ABOUT THIS POSITION
Waystar is seeking a smart, technical and creative Enterprise Rules & Edits Analyst seeking a chance to grow their career and work with claim billing & coding/authorization rules. This analytical, solution-oriented individual will report to a Director of Enterprise Rules & Edits and work closely with client support and technology teams. This role will serve as an expert in government and payer requirements, focusing on how to help our clients improve clean claim rates and reduce denials against those constraints.WHAT YOU'LL DO
•This cross-functional position will work with product, client support and technical teams to deliver accurate, timely claim edit/authorization rule configurations.
• Studying healthcare industry standards and staying up-to-date on industry changes and compliance issues, focusing on government/payer requirements for claims billing & coding/authorization
• Leverage analytical tools (Excel, PowerBI, SQL Databases) to identify trends and outliers in EDI 837/835/278 transaction data
• Transform data into actionable claim edits, policy recommendations or authorization rule configurations
• Configuring system settings and options; plans and executes unit, integration and acceptance testing
• Subject matter expert in medical billing and coding, authorization rules and requirements, EDI 835/837
• Consult with high-value clients to optimize claim edit/authorization rule configurations
• Develop sustainable processes and systems to ensure claim edits are accurately and efficiently maintained.
WHAT YOU'LL NEED
• Bachelor’s degree or 2-4 years of equivalent experience in healthcare setting
You know how to execute and like to roll up your sleeves to get things done
• An understanding and knowledge of hospital revenue cycle workflows and the provider reimbursement process from patients and payers obtained either through direct experience in a healthcare setting or an RCM focused HIT company
• Problem solving skills; able to analyze a problem and design creative solutions
• Possess planning and organization skills to independently develop and lead projects when applicable
• Excellent written communication skills; able to succinctly convey complex ideas through writing
• Flexible and agile; able to rapidly adapt to changing situations and inputs
• Medical claims coding certification preferred
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
- Bachelor's degree or 2-4 years of equivalent experience in healthcare setting
- Understanding of hospital revenue cycle workflows and provider reimbursement process
- Medical claims coding certification
Waystar Compensation & Benefits Highlights
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Leave & Time Off Breadth — Time off is described as generous, including PTO, numerous paid holidays, and flexible time off options that support work–life balance. Policies such as volunteer time off and flexible/unlimited PTO for some roles further expand usable leave.
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Healthcare Strength — Benefits include multiple medical plan choices with HSA company matching and access to mental‑health resources. Additional wellness perks and coverage options contribute to a comprehensive healthcare offering.
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Parental & Family Support — Paid parental leave and family‑planning benefits, including adoption and fertility support, are included. These elements are positioned as supportive of different life stages.
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.
