Claim Data Integrity Analyst

2 weeks ago

Salt Lake City, United States Waystar Full time

ABOUT THIS POSITION

Function as an Analyst, Claim Data Integrity for EDI rejections with Waystar client support, trading partners and intermediaries. Analyst must fully understand payer rejections, payer edits and all associated code set requirements. Effectively communicate and interpret rejection messages correctly and improve the department processes and procedures to ensure the highest value possible for our customers. The Analyst will work with multiple Waystar departments to limit the number of claims that are rejected by payers and intermediaries.

WHAT YOU'LL DO

Enable customer self-sufficiency in resolving claim issues by researching, analyzing, and addressing claim rejections and responses. Ensure that the parent case owner is provided with a reasonable update every two business days on the case progress Contact intermediaries and payers to consult with them about specific rejection messages and/or coach them on how to best alter it appropriately Connect with client support to discuss more efficient methods of giving response messages to enable them to resolve their rejections more easily Proactively map raw payer/intermediary rejections and produce more “friendly” client-facing messages Monitor and keep up with payer changes and how to accommodate new requirements internally Constantly pursue better responses or claim level acknowledgements for both rejected and accepted claims Continuously encourage and evaluate the use of solution articles Establish webinars and /or alerts on a monthly/quarterly schedule to go through top rejections and how to resolve Maintain a full understanding of claim response reports Perform other duties and /or projects as assigned by management within the area of responsibility and control Can work all functions within Claim Data Integrity including To-do Cases, Validations, Tech Cases, and Mapping

WHAT YOU'LL NEED

Demonstrated project management skills. Excellent written and verbal communications skills. Excellent analytic and problem-solving skills. Knowledge of Windows-based computer environment, including MS Office and related programs. Active ownership and responsibility regarding duties and tasks. Ability to work unsupervised in a corporate environment. Knowledge of healthcare claims transactions. 2-year or 4-year college degree or equivalent experience. EDI X12 healthcare transaction experience. General SQL knowledge

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 PERKS

Competitive total rewards (base salary + bonus, if applicable) Customizable benefits package (3 medical plans with Health Saving Account company match) Generous paid time off starting at 3 weeks + 13 paid holidays including 2 personal floating 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

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