Name: Zelis Claims Editing
Rating: 3 (1 reviews)

Overview

Product Information on Zelis Claims Editing

Updated 13th October 2025

What is Zelis Claims Editing?

Zelis Claims Editing is a software designed to assist healthcare payers and providers in managing the accuracy and compliance of health insurance claims. The software automates the process of identifying errors, inconsistencies, or deviations from standard billing practices within submitted claims. It integrates with claims processing systems to analyze and validate coding, modifiers, and medical necessity based on industry guidelines and payer policies. The software aims to reduce improper payments, streamline adjudication, and enhance operational efficiency in claims management. By applying configurable rules and edits, it helps organizations address claim discrepancies and control costs associated with claim rework and denials.

Overall experience with Zelis Claims Editing

There are no reviews in this category.

FAVORABLE

Legal and Compliance Associate

50M - 250M USD, Insurance (except health)

CRITICAL

“Excellent Finance Function with Stellar Customer Service and API Customization”

3.0

Jun 3, 2025

Customer service has been stellar. No complications with the finance function.

About Company

Company Description

Zelis is a company that has set out to modernize healthcare by establishing a connected platform that addresses gaps in the financial system and aligns the needs of healthcare insurance providers, healthcare providers, and consumers. The platform is revolutionizing the monetary aspect for numerous payers including national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers and many providers and consumers. It oversees the financial experience to pinpoint, enhance, and tackle issues in a holistic manner with technology created by healthcare experts, thereby generating tangible, quantifiable results for the clients.

Company Details

Company type

Private

Head office location

Boston, United States

Number of employees

1001 - 5000

Website

https://www.zelis.com

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Reviewer Insights for: Zelis Claims Editing