Medical Document Retrieval Specialist

Doc Retrieval II

About Us 

Zelis is modernizing the healthcare financial experience in the United States (U.S.) 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.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

Why We Do What We Do 

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

objECTIVES AND RESPONSIBILITIES:

Successfully manages both medical record claim audit requests and facility itemized bill claim requests.

Manages 2 or more nurse auditor staff in the medical claim audit process by requesting medical records and applicable documents from medical providers nationwide.

Contacts healthcare providers to request and obtain medical and billing documents via phone, fax, mail & e-mail for claims processing.

Organize and prioritize claims daily for follow up of billing documents not received.

Learn and process according to various provider/client stipulations.

Utilize AutoFax – document retrieval platform efficiently.

Performs other related responsibilities as assigned.

Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.

 

What You Will bring:

Has foundational proficiency in requesting medical records and applicable documents from medical providers.

2+years of medical record experience or 1+year prior DR I experience.

Has a solid understanding of various types of medical documents.

Has a solid understanding of processes and techniques in obtaining documents.

Great verbal communication skills

Knowledge of MS Outlook, MS Word, & Internet Explorer

Strong prioritizing & organizational skills

Excellent customer service & telephone skills

Independence/ Accountability:

Meets or exceeds the Document Retrieval Performance Standards established by the Document Retrieval department.

Requires minimal daily supervision on day to day tasks but seeks guidance on more complex tasks

Accountable for day to day tasks

Ability to follow detailed instructions on new assigments

Must have professional manner and respect the confidentiality of administrative matters and files

Ability to manage and prioritize multiple tasks.

Ability to work under pressure and meet deadlines.

Completes work in a timely fashion

Outstanding ability to multiplex tasks as required

Attention to detail.

 

Communication Skills:

Must work well with others

Effectively communicates with others by giving and receiving feedback

Call Center Phone edicate

Communicates ideals and information clearly

 

 

education:

Graduate

Associates Degree a plus

Commitment to Diversity, Equity, Inclusion, and Belonging

At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

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.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability and require reasonable accommodation with any part of the application and/or interview process, please email talentacquisition@zelis.com.

Experience Level

Entry Level