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Audit Analyst

zelis.com Logo

Zelis

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Location:
India , Hyderabad

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Category:

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

The Audit Analyst will be responsible for conducting thorough audits of process, ensuring compliance with Regulatory Pricer Product standards and identifying areas of improvement.

Job Responsibility:

  • Perform details audits on operational processes and validate compliance with internal polies and external regulations
  • Analyze data and operational metrics to identify discrepancies, trends and areas of improvement
  • Conduct in-depth research of pricing issues, system related problems and policy and procedure challenges to confirm root cause. Recommend actions/resolutions
  • Prepare comprehensive audit reports, summarize findings and provide actionable recommendations to managements
  • Ensure adherence to regulatory and business requirements and internal controls
  • Identify areas of potential risk and develop strategies to mitigate them
  • Collaborate with varies departments to implement process improvements and enhance operational efficiency
  • Maintain accurate and up-to-date audit documentation and records
  • Provide training and support to staff on audit related matters
  • Support multiple audit projects, initiatives and tasks while adhering to deadlines
  • Maintain awareness of and ensure adherence to Zelis standards regarding privacy

Requirements:

  • 2 years of relevant experience or equivalent combination of education & work within healthcare payer or provider
  • Knowledge of healthcare reimbursement methodologies and acceptable billing practices
  • Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards
  • Knowledge of claims adjudication process and interpret claim editing rules
  • Proficient in Microsoft Office, Word, Excel
  • Excellent written, oral and presentation skills and ability to communicate complex concepts

Nice to have:

  • Certified coder (CCS, CCS-P or CPC), or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge
  • Understanding of SQL Server 2000/2005/2008
  • Project management experience
What we offer:
  • Hybrid work flexibility
  • Comprehensive healthcare benefits
  • Financial wellness programs
  • Cultural celebrations

Additional Information:

Job Posted:
February 20, 2026

Expiration:
February 28, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
Job Link Share:

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