ECR-IBR Reviewer I – Hyderabad, India
Zelis is seeking a detail-oriented and analytical ECR-IBR Reviewer I to join our growing team in Hyderabad, India. In this role, you will be responsible for performing External Claims Review (ECR) and Independent Bill Review (IBR) tasks, ensuring accuracy and compliance with U.S. healthcare reimbursement policies. If you have a background in healthcare, strong analytical skills, and a passion for contributing to improvements in the U.S. healthcare financial experience, we encourage you to apply.
Job Summary
As an ECR-IBR Reviewer I, you will play a vital role in ensuring the accuracy and integrity of medical claims processing. You will analyze claim details, medical documentation, and payer guidelines to determine appropriate reimbursement. This position requires a strong understanding of U.S. healthcare processes and the ability to work collaboratively with cross-functional teams.
Responsibilities
- Perform ECR (External Claims Review) and IBR (Independent Bill Review) tasks in accordance with established policies and procedures.
- Thoroughly analyze claim details, medical documentation, billing patterns, and payer guidelines to ensure accuracy and compliance.
- Ensure alignment with U.S. healthcare reimbursement policies and regulations.
- Collaborate effectively with cross-functional teams to investigate and resolve claim discrepancies.
- Maintain accurate and complete documentation, including audit trails, related to all review activities.
- Adhere to established productivity standards and quality metrics.
- Contribute to continuous improvement initiatives within Zelis India to enhance processes and efficiency.
Requirements
- Bachelor’s degree in Life Sciences, Pharmacy, Healthcare, or an Allied Health field is preferred.
- Experience in medical claims review, U.S. healthcare processes, or payment integrity is a significant advantage.
- Demonstrated strong analytical and problem-solving skills.
- Exceptional attention to detail and a commitment to accuracy.
- Proficiency in documentation and record-keeping.
- Effective communication skills, both written and verbal.
- Ability to collaborate effectively within a global team environment.
- Ability to thrive in a structured, fast-paced operational setting.
- Must be able to learn quickly and adapt to changing requirements.
Benefits
Zelis offers a comprehensive and competitive benefits package designed to support the well-being of our employees and their families. Our benefits include:
- Competitive salary and performance-based incentives.
- Flexible work arrangements, including hybrid work options.
- Comprehensive healthcare benefits, including medical, dental, and vision coverage.
- Financial wellness programs to assist with retirement planning and other financial goals.
- Mental wellbeing programs to support employee mental health and work-life balance.
- An inclusive, diverse, and global work environment where every employee is valued and respected.
- Leadership development and learning support opportunities to help employees grow and advance their careers.
- Opportunities to participate in U.S. healthcare innovation projects and contribute to meaningful change in the industry.
How to Apply
If you are a motivated and talented individual seeking an opportunity to contribute to a leading healthcare financial technology company, we encourage you to apply. Please submit your application online through our careers website. We look forward to hearing from you!