IBR Facility Reviewer Job in Hyderabad at Zelis India for healthcare claims review professionals with coding, billing, and insurance experience.
About the Company
Zelis is a leading healthcare technology company focused on modernizing the healthcare financial experience in the United States. The organization works across payers, providers, and healthcare consumers to simplify complex financial processes, improve transparency, and enhance efficiency across the healthcare ecosystem. IBR Facility Reviewer Job in Hyderabad at Zelis
Zelis serves more than 750 healthcare payers, including the top national and regional health plans, third-party administrators (TPAs), and millions of healthcare providers and consumers. By combining advanced technology with deep healthcare expertise, Zelis delivers measurable and meaningful outcomes for its clients.
Zelis India plays a vital role in supporting global operations and innovation. The India team contributes to product development, operational excellence, and process optimization while working closely with global stakeholders. Employees at Zelis India benefit from a collaborative work culture, leadership development opportunities, global exposure, and a holistic workplace experience that supports both professional and personal growth. IBR Facility Reviewer Job in Hyderabad at Zelis
Job Details
- Job Title: IBR Facility Reviewer (Itemized Bill Review – Facility Reviewer I)
- Company: Zelis
- Location: Hyderabad, India
- Employment Type: Full Time
- Job Requisition ID: JR109490
- Application Deadline: February 28, 2026
- Work Model: Hybrid (as per company policy)
This role is ideal for healthcare professionals with experience in medical billing, coding, and insurance claims who are looking to grow their careers with a global healthcare technology organization. IBR Facility Reviewer Job in Hyderabad at Zelis
Job Description
The IBR Facility Reviewer at Zelis is responsible for reviewing and analyzing facility inpatient and outpatient claims for health plans and TPAs. The primary objective of this role is to ensure claims adhere to appropriate billing, coding, and reimbursement guidelines.
This is a production-driven position with clearly defined productivity and quality benchmarks. The reviewer works closely with hospital bill review teams and concept development staff to identify billing inaccuracies, apply payer policies accurately, and support efficient claims processing. IBR Facility Reviewer Job in Hyderabad at Zelis
The role requires strong attention to detail, solid knowledge of medical coding standards, and the ability to handle high-value claims while maintaining accuracy and compliance with internal and external guidelines.
IBR Facility Reviewer Job in Hyderabad at Zelis
Key Responsibilities
- Conduct detailed reviews of hospital itemized bills for inpatient and outpatient claims.
- Identify billing and coding errors across all payer claims using established guidelines.
- Work closely with hospital bill review and concept development teams to ensure consistency and accuracy.
- Translate client reimbursement policies into Zelis-specific coding and clinical concepts.
- Understand payer-specific policies and ensure their correct application during claims processing.
- Prepare and upload clear, concise, and accurate documentation outlining review findings.
- Accurately calculate and verify financial impact and savings identified during the review process.
- Monitor multiple reports to track client-specific requirements, turnaround times, and claim progression.
- Maintain an average productivity standard of at least 10 processed claims per day.
- Consistently meet or exceed the individual quality benchmark of 85 percent.
- Review and manage a wide range of claim types with charge values up to $500,000.
- Collaborate with cross-functional teams within the department to resolve complex issues.
- Follow standard operating procedures while proactively suggesting improvements.
- Stay current with national coding guidelines, including Official Coding Guidelines and AHA Coding Clinic updates.
- Share coding updates and best practices with team members.
- Ensure strict adherence to Zelis privacy, security, and compliance standards.
IBR Facility Reviewer Job in Hyderabad at Zelis
Skills/Qualifications
Educational Qualifications
- Graduate degree in any discipline.
- Additional certifications in medical coding or billing are highly valued.
Certifications
- CPC (Certified Professional Coder) credential is preferred.
Experience
- 1 to 2 years of applicable healthcare experience preferred.
- Prior exposure to medical claims review, hospital billing, or insurance operations is advantageous.
Technical and Functional Skills
- Strong working knowledge of health and medical insurance processes.
- Understanding of provider claims and hospital billing methodologies.
- Hands-on knowledge of ICD-10 and CPT coding systems.
- Ability to manage multiple tasks and prioritize workload effectively.
- High attention to detail with strong analytical skills.
- Accountability for daily deliverables and performance metrics.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office Suite, including Excel and Word.
IBR Facility Reviewer Job in Hyderabad at Zelis
Benefits/Perks
Zelis offers a comprehensive benefits package designed to support employee well-being and career development: IBR Facility Reviewer Job in Hyderabad at Zelis
- Competitive salary aligned with industry standards.
- Hybrid work flexibility promoting work-life balance.
- Comprehensive healthcare and wellness benefits.
- Financial wellness programs and employee assistance initiatives.
- Opportunities for global exposure and cross-functional collaboration.
- Continuous learning and professional development support.
- Inclusive and diverse workplace culture.
- Participation in cultural celebrations and engagement activities.
IBR Facility Reviewer Job in Hyderabad at Zelis
Why You Should Join
Zelis provides an opportunity to be part of a mission-driven organization that is transforming the healthcare financial landscape in the United States. By joining Zelis India, you become part of a global team that values innovation, collaboration, and accountability. IBR Facility Reviewer Job in Hyderabad at Zelis
The IBR Facility Reviewer role offers hands-on exposure to complex healthcare claims, payer policies, and high-value reviews. It is an excellent career path for professionals seeking stability, skill enhancement, and long-term growth in healthcare operations, medical billing, and claims analytics.
Zelis’ strong emphasis on diversity, equity, inclusion, and belonging ensures that employees feel valued and empowered to bring their authentic selves to work every day. IBR Facility Reviewer Job in Hyderabad at Zelis
How to Apply
FAQs
Q1. Is this a full-time role?
Yes, this is a full-time position based in Hyderabad, India.
Q2. What experience level is required for this role?
Candidates with 1–2 years of healthcare, medical billing, or claims experience are preferred.
Q3. Is CPC certification mandatory?
CPC is preferred but not mandatory. Relevant experience and coding knowledge are also considered.
Q4. What type of claims will be reviewed?
The role involves reviewing inpatient and outpatient hospital facility claims with values up to $500,000.
Q5. What are the productivity expectations?
Reviewers are expected to process an average of 10 claims per day while maintaining quality standards.
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