ABOUT THIS POSITION
The Revenue Integrity Review Specialist is responsible for conducting high-quality medical record reviews on behalf of Waystar Customers. This role leverages advanced Coding and Clinical Documentation Integrity (CDI) expertise to identify documentation, coding, and reimbursement opportunities while ensuring compliance with industry standards and regulatory requirements.The ideal candidate demonstrates exceptional attention to detail, strong critical thinking skills, and the ability to maintain a high level of accuracy, quality, and productivity in a production-based review environment. The Revenue Integrity Review Specialist consistently delivers efficient, clinically supported, and compliant review outcomes that align with customer expectations.
WHAT YOU'LL DO
Key Responsibilities
Medical Record Review and Analysis
Conduct comprehensive medical record reviews to identify Coding, CDI, Quality and revenue integrity opportunities.
Apply advanced knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG methodology, CDI principles, and clinical validation concepts to evaluate documentation accuracy, code assignment, and clinical support.
Identify documentation accuracy opportunities and develop compliant physician queries when clarification is needed.
Ensure all review findings and recommendations are accurate, clinically supported, compliant, and aligned with Official Coding Guidelines, AHIMA/ACDIS Query Practice Briefs, regulatory requirements, and customer-specific standards
Quality, Productivity, and Performance
Consistently achieve established productivity, quality, accuracy, and turnaround time standards while managing a high volume of reviews.
Prioritize workload effectively and work independently in a fast-paced production environment.
Maintain current knowledge of coding, CDI, reimbursement methodologies, clinical practice standards, and regulatory changes affecting review outcomes.
Deliver high-quality review results that meet customer expectations and organizational performance standards.
WHAT YOU'LL NEED
Minimum Qualifications
BSN, RHIA, RHIT, CCS, CCDS, CDIP, or equivalent healthcare credentials.
3-5 years of experience in inpatient coding, CDI, revenue integrity, auditing, or related healthcare field.
Strong knowledge of ICD-10-CM/PCS coding guidelines, CDI practices, MS-DRG assignment, clinical validation, and physician query best practices.
Demonstrated ability to achieve productivity, quality, and accuracy standards in a high-volume review environment.
Strong analytical, critical thinking, and communication skills with the ability to work independently and manage competing priorities.
Preferred Qualifications
Dual certification (CCDS/CDIP and CCS) or willingness to obtain additional certification.
Experience reviewing records within healthcare technology platforms, such as Prebill or similar clinical review solutions.
ABOUT WAYSTAR
Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle.
Waystar’s healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun.
Waystar products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit waystar.com or follow @Waystar on Twitter.
WAYSTAR PERKS
- Competitive total rewards (base salary + bonus, if applicable)
- Customizable benefits package (3 medical plans with Health Saving Account company match)
- We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays
- Paid parental leave (including maternity + paternity leave)
- Education assistance opportunities and free LinkedIn Learning access
- Free mental health and family planning programs, including adoption assistance and fertility support
- 401(K) program with company match
- Pet insurance
- Employee resource groups
Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Skills Required
- Comprehensive understanding of medical terminology
- Knowledge of anatomy and physiology
- Quality control skills
- Current knowledge on CPT, ICD, HCPC coding requirements
Waystar Compensation & Benefits Highlights
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Healthcare Strength — Medical, dental, and vision coverage is broad, with multiple plan choices and HSA support highlighted. Mental-health resources and wellness programs extend coverage beyond the basics.
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Parental & Family Support — Paid parental leave for maternity, paternity, and adoption is explicitly provided, alongside fertility and family‑planning support. Childcare benefits and a post‑parental return‑to‑work program further reinforce family coverage.
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Leave & Time Off Breadth — Generous PTO, paid holidays, and paid volunteer time off are consistently emphasized. Some roles use flexible or unlimited time off, adding additional latitude for time away.
Waystar Insights
What We Do
Waystar harnesses the power of agentic AI, generative AI, and advanced automation to drive meaningful outcomes so providers reach peak financial performance and patients receive care with confidence. The Waystar platform is used by more than 1 million providers and supports over 60% of the U.S. patient population - and integrates with all major HIS and practice management systems. The financial and administrative challenges facing healthcare providers are daunting. Waystar’s technology platform simplifies and unifies healthcare payments across the revenue cycle. We empower healthcare organizations to automate manual work, gain insight into processes and performance, and ultimately collect more revenue. At Waystar, we know there’s a better, more efficient way forward. Let’s climb the mountain ahead of us to reach new heights in healthcare.
Why Work With Us
Our Waystar values serve as a compass to center our decisions, inspire action, and promote outstanding performance. We are dedicated to providing a diverse, inclusive workplace and fostering a shared sense of belonging.
Waystar Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
