23 hrs ago
Senior Content Ideation Specialist
Zelis
Morristown, NJ (Hybrid)Full time$105K/yr – $133K/yr
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Senior Content Ideation Specialist
Morristown, NJ (Hybrid)
$105K/yr – $133K/yrSenior Level6+ years expFull time
Posted 23 hrs ago
Job Summary
Own and drive content and DRG validation initiatives for itemized bill review, including disputes, regulatory research, and education across Operations, CMO, and Product teams.
- Manage content maintenance, dispute rationales, and DRG policies as core workstreams.
- Collaborate with cross-functional teams to implement updates, educate stakeholders, and monitor regulatory changes.
Job Description
Responsibilities
- Serve as subject matter expert for the Ideation Team on day-to-day activities including troubleshooting and review for data accuracy
- Review provider disputes for DRG and IBR and submit explanation of dispute rationale back to providers based on dispute findings within the designated timeframe to ensure client turnaround times are met
- Serve as a subject matter expert for content and bill reviews and provide support where needed for inquiries and research requests
- Create and present education to Operations team and CMO along with potentially other departments on new and updated concepts, review guidelines, and dispute findings
- Research and analysis of content for Itemized Bill Review and DRG Validation
- Use of strong coding and industry knowledge to create and maintain bill review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies, and Dispute Rationales
- Perform regulatory research from multiple sources to keep abreast of compliance enhancements and additional bill review opportunities.
- Analysis of data to assess impact for content related issues or defects. Contribute to product alerts and partner with Product Management on notifications
- Utilize the most up-to-date approved Zelis medical coding sources for bill review maintenance and development
- Partner with other areas to assess and communicate impact to the business for additions, changes, or updates as it relates to content and bill review updates
Requirements
- Current, active CIC or CCS or equivalent credentialing is required
- RN or LPN with coding certification, or certified coder, or registered health information technician (RHIA/RHIT) with at least 6-8 years of experience
- Experience with MS-DRG/APR-DRG coding and compliance required
- Experience performing regulatory research from multiple sources, formulating an opinion, and presenting findings in an organized, concise manner
- Knowledge of National Medicare and Medicaid regulations
- Knowledge of payer reimbursement policies
- Creative problem-solving skills, leveraging insights and input from other parts of an organization
- Ability to leverage reporting tools to research claim data, trending and analysis for concept ideation processes
- Understanding of JIRA/Confluence recommended
- Strong organization and project/process management skills
Benefits
- Zelis full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection.
- The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.
Zelis
3.8 Glassdoor
Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.Zelis maintains a transparent, fee-free recruitment process. All genuine offers originate from our Talent Acquisition team using the “@ zelis.com” domain. We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to verify-offers[@]zelis.com for prompt investigation. Thank you for staying vigilant.
Founded in 2016
Boston, Massachusetts, USA
2.7K employees (133 in marketing)
66% recommend to a friend
80% CEO approval
Salaries
Posted range
$105K/yr – $133K/yr
Taken straight from the job posting.
Marketing Team
Marketing Team Size
87 (3% of company)
Median Career Experience
15 years
Median Tenure
2.9 years
Marketing Roles Posted (Last 30 Days)
1
People
HR / Recruitment
Marketing Leadership
Heather Valteris
Chief Marketing Officer
At the company for 4 years 7 months
D. Matthew Carter
SVP of Digital Marketing
At the company for 1 year 4 months
Audrey Veitas
Vice President of Segment Marketing
At the company for 2 years 4 months
Lizzy Feliciano, MBA, PMC, MCMP-II
VP, Product Marketing - Price Optimization
At the company for 2 years 8 months
Funding
Total Funding
$20.1M
Last Raise
$20.1M
Private Equity, 1 years ago
Funding History
- Dec 2024Private Equity
- Jan 2020Private Equity • $20.1M
- Jan 2019Private Equity
Traffic Signals
Monthly Visitors
314.8K
Monthly Google Ads Budget
$81.6K
Traffic Source Mix
Search
28.2%
Direct
63.6%
Referral
7.2%
Social
0.1%
Paid
0.9%
Headcount Trend
Current headcount: ~2.7K
Recent News
Links
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