Contract Analyst US TX Plano

At Zelis, we Get Stuff Done. So, let’s get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. A Little About You You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons youve learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge youve gained, and the personal interests that shape who you are. Position Overview This position requires an incumbent to analyze healthcare reimbursement contracts and load contract terms between payers and providers in an accurate and timely manner using proprietary software. This position reports to the Manager of Contract Configuration and will collaborate with the programming and development teams in the creation and vetting of calculation methods, database loads, or changes. This position is an internal resource to staff and clients and as such is expected to respond to client issues and cases in a timely manner. What youll do:

• Set up basic contract loads: simple single case agreements (SCAs), basic % of billed charges (BCs), basic % of Medicare, general carve-out codes and basic fee schedule set up.
• Interpret complex contract terms, analyze reimbursement methodologies, and rate structures (e.g., DRG, APC, CPT/HCPCS, ICD-10).
• Load, maintain, and audit client contracts within the adjudication system.
• Validate and test contract configurations for claims pricing accuracy.
• Maintain fee schedule in contract databases and apply annual escalators for client auto renewals.
• Link contracts to payer products, update and maintain provider groups within client databases to ensure seamless claims routing.
• Handles confidential material on a regular basis and is responsible for protecting the confidentiality of such information within the established guidelines of Company and law. (HIPAA Compliance)

What youll bring to Zelis:

• 4+ years of relevant experience
• Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field
• Microsoft product proficiency. Must be an intermediate to expert user of Excel
• Possess strong analytical and math skills
• Self-Motivated and Detail Oriented
• Effective written and verbal skills, communicate effectively & expresses ideas clearly and succinctly.
• Seeks opportunities for continuous learning. Modifies behavior in response to feedback.
• Delivers high quality work and attains results.
• Prioritizes the importance of tasks and goals. Manages time efficiently to accomplish priorities and overcome obstacles.
• Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employees work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don’t meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email [email protected]. Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time. Apply tot his job Apply To this Job