What are the responsibilities and job description for the Payment Recovery Specialist position at Zelis?
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 you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.
Position Overview
The Payment Recovery Specialist is responsible for identifying, researching, and resolving payment recovery issues with a primary focus on recoupment and collections from healthcare providers. This role supports recovery of outstanding amounts owed to Zelis related to payment activity, including failed ACH transactions, incorrect funding, reversals/returns, misapplied funds, and provider refund/recoupment activity.This position requires working knowledge of ACH/payment processing (including NACHA return codes), strong problem-solving and documentation skills, and the ability to conduct effective provider outreach (inbound and outbound) to drive timely resolution.
What You’ll Do
- Drive payment recovery and provider collections outcomes by contacting healthcare providers to pursue recoupment, refunds, and unpaid balances tied to payment activity; negotiate resolution timelines and ensure commitments are documented and tracked.
- Partner with Finance and cross-functional teams to identify payment discrepancies, validate amounts owed, and ensure recovery efforts are aligned to financial controls and documentation standards.
- Maintain a disciplined work queue and follow-up cadence; prioritize outreach and recovery actions based on aging, dollar impact, and risk.
- Document all actions and outcomes in applicable systems; maintain clear audit trails for provider outreach, dispute status, and recovery results.
- Handle and facilitate disposition of escalated client/provider issues; communicate status and next steps clearly to internal and external stakeholders.
- Support team knowledge-sharing by contributing to job aids, updating FAQs, and helping newer team members with process/system questions as needed.
- Adhere to all internal policies and procedures, confidentiality standards, and applicable regulatory requirements.
What You’ll Bring to Zelis
- 1–3 years of experience in a recovery/collections function, with healthcare provider A/R or provider collections experience strongly preferred (e.g., provider refund recovery, overpayment recoupment, or related provider receivables work).
- Strong customer service and phone communication skills; comfort with persistent follow-up and collection-oriented conversations.
- Excellent organizational skills; ability to manage multiple priorities, meet deadlines, and work accurately under pressure.
- Strong written communication skills for professional provider/client outreach and internal documentation.
- Proficiency in Microsoft Office / Microsoft 365 (especially Excel and Outlook/Teams).
- Ability to learn and effectively use proprietary systems and follow detailed procedures.
- High School Diploma or equivalent required; Additional relevant education or equivalent experience preferred.
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 employee's 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
TalentAcquisition@zelis.com
.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.