Strategic Enterprise Claims Rules & Edits Analyst
Waystar
A leading healthcare technology firm is seeking a smart, technical, and creative Enterprise Rules & Edits Analyst. This full-time role involves working with claim billing, coding, and authorization rules. Key responsibilities include collaborating with client support and technology teams, leveraging analytical tools, and developing processes for accurate claim edit configurations. Ideal candidates will have a degree or equivalent experience in healthcare and strong problem-solving and communication skills. Competitive benefits and flexible time off are offered. #J-18808-Ljbffr Waystar
- Waystar is seeking a smart, technical, and creative Enterprise Rules & Edits Analyst to grow their career working with claim billing, coding, and authorization rules. The analyst will report to the Director of Enterprise Rules & Edits and collaborate with client support...ClaimsFull timeLocal areaFlexible hours
- Enterprise Rules & Edits Analyst page is loaded## Enterprise Rules & Edits Analystremote type: Client Operationslocations: Louisville, KYtime type:... ...Analyst seeking a chance to grow their career and work with claim billing & coding/authorization rules. This analytical,...ClaimsLive outLocal areaFlexible hours
- ...Provides lead level analyst support for health... ...(PI) and provider claims accuracy. Makes... ...are met for pre-pay edits, post-payment... ...operational teams, enterprise stakeholders, and... ...duties as assigned. Strategic Business Analysis... ...Medicaid payment rules. Strong data analysis...ClaimsTemporary workWork at officeRemote work
- ...Operations organization, the Manager, Strategic Pharmacy Analyst (SPA), will manage a team of diverse and... .../PBM contracts including utilization rules, B/G classification, discount... ...disruption, contract language, group size, claim utilization, clinical trend, and appropriate...ClaimsContract workTemporary workLocal areaRemote work
- ...leading healthcare technology company located in Louisville, KY is looking for an Enterprise Rules & Edits Analyst to enhance their revenue cycle services. The role involves configuring claims billing rules, analyzing transaction data, and consulting with clients to...ClaimsRemote jobFlexible hours
$90k - $150k
...We are seeking an experienced business analyst to work across teams to assist with a massive multiyear modernization of our enterprise infrastructure, including significant cloud... ...of any kind, pursuing any discrimination claim, or cooperating in related investigations....ClaimsWork at officeLocal areaRemote work$49.43k - $107.1k
...and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information... ...data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider...ClaimsWork experience placementWork at office- ...The Business Analyst, Pricing and Underwriting , is responsible for the compilation,... ...financial forecasting, and contribute to strategic economic modeling. Design and generate reports... ...business strategy. Analyze pharmacy claims, drug pricing, rebate models, and...ClaimsFull timeTemporary workWork at officeRemote workWork from home
- ...ABOUT THIS POSITION The Strategic Solutions Analyst will act as a liaison between Waystar and our most strategic clients and partners. This is accomplished by handling inbound inquiries by phone and email, as well as conducting proactive analysis of assigned clients...Full timeLive outWork at officeLocal areaFlexible hours
- ...for a Salesforce Operations Analyst III to join our team! In this... ...and enhance ARC’s CRM and ERP enterprise systems. This role requires expertise... .... You will contribute to strategic organizational projects by... ...configure security/sharing rules, permission sets, permission...Work at officeWork from homeFlexible hours
- ...Business Analyst(BA) Pharma Location: Louisville, KY H1b's accepted. Pharma domain (at least one project) needed Required... .... ~ Understanding of overall process flow among eligibility, claims, benefit systems. ~ Understanding of needs and challenges in...ClaimsH1b
$96.4k - $120.5k
...performance teams? Join WWT today! What will you be doing? IT Senior Analyst position will assist in requirement collection and refinement... .... This position will serve as an IT Senior Analyst for the Strategic Partner Integration (SPI) team. RESPONSIBILITIES: Gather...Permanent employmentFull timeWork experience placementH1bRemote workVisa sponsorshipShift work$50k
...a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize...Full timeTemporary workWork at officeImmediate startHome office- CCCA Analyst (Credit and Accounts Receivable Analyst) We believe great people build great... ...collection of overdue accounts, claims adjustment, and credit hold release. This... ...example: Google, Excel, and SAP or other enterprise system (input and query experience). Ability...ClaimsFlexible hours
- Senior Revenue Integrity Pharmacy Analyst, Revenue Integrity/Coding Administration, Days Responsibilities The Sr. Revenue Integrity Pharmacy... ..., and value analysis. They will review and analyze pharmacy claims, collaborating with pharmacy IS, Billing and Managed Care to...ClaimsFull timeRemote work
$49.43k - $107.1k
...Louisville, Kentucky, is seeking a qualified candidate to ensure accurate and timely maintenance of critical provider information across claims and provider databases. This role requires at least 2 years of health care experience along with skills in data analysis, Microsoft...ClaimsWork at office$72.48k - $121.44k
...In this position...? The Quality Analyst will report to the Plant Vehicle Evaluation Manager. They will complete assignments from the... ....? What you'll do... Assist reviewing and binning early claims binning claims and customer concerns with PVT engineers. Support...ClaimsPermanent employmentInterim roleWork at officeImmediate startFlexible hours- ...and execution for our largest and most strategic vertical. This is a high-impact, fast-moving... ...resonate with carriers, adjusters, and claims leaders. Lead competitive intelligence... ...marketing enablement and content support for enterprise pursuits, renewals, and key product...ClaimsTemporary workLocal area
$50k - $60k
...to making that happen. The CX Research & Modeling Analyst will be a technical owner and architect of our AI enterprise text analytics program within Qualtrics Engage /... ...language processing (NLP) and machine learning to build rule-based topic models, tagging structures, and...Work at officeWorldwide- Presque Isle Downs, Inc. is seeking a Settlements Revenue & Accounting Analyst in Louisville, KY. This role involves managing pari-mutuel invoicing, communication with third-party customers, and performing month-end closing duties. Candidates should possess a Bachelor's...
$172.2k - $236.9k
...Solutions Strategist provides strategic advice and guidance to... ...-making across the enterprise. In this high-impact... ...and Medicaid), claims, pharmacy, clinical systems... ...Define and enforce rules for systems of record... ...leaders and business analysts to understand end-to-end...ClaimsFull timeTemporary workFor contractorsApprenticeshipRemote workWork from homeHome office$96.4k - $120.5k
...documentation, this is it. Sr. IT Business Analyst – Sales Enablement The Business... ...domains through process maps, flows, business rules, and decision logic, especially across... ...healthy balance of detail orientation and strategic thinking—knowing when precision matters...Full timeShift work- ...solutions with bottom-line financial impact. USI ONE® represents Omni, Network, Enterprise—the three key elements that set USI apart from the competition. Through USI ONE, we develop strategic, timely, and effective risk management and benefit programs in terms that are...Temporary workWork at officeLocal areaFlexible hoursAfternoon shift
- ...and machine learning models that improve claims outcomes, operational efficiency, and... ...productionize models and integrate them into enterprise AI platforms and operational systems.... ...technical guidance to data scientists and analysts across the organization. Mentor...ClaimsRemote work
$22 per hour
...and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications,... ...Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient...ClaimsTemporary workWork experience placementMonday to FridayFlexible hoursShift workWeekend work- ...and deploy LLM-powered and agentic AI solutions that transform claims intake, policy interpretation, fraud detection, and resolution... ...to-end retrieval-augmented generation (RAG) systems leveraging enterprise knowledge bases, policy documents, SOPs, and historical claims...Claims
- ...ensuring alignment with business objectives, enterprise architecture standards, and scalability... .../downstream platforms such as billing, claims, procurement, HR, and analytics systems... ...Support chart of accounts design, accounting rules, and historical data loads Lead...ClaimsFull timeRemote work
- Brown-Forman is hiring an IT Governance/Risk/Compliance Analyst in Louisville, KY. This role involves developing and maintaining IT governance frameworks, supporting risk management programs, and ensuring compliance with internal policies and external regulations. The ideal...
- ...in insurance and risk management, with at least 10 years of relevant experience. You will also manage relationships with underwriters and brokers and provide oversight for insurance claims, ensuring alignment with organizational objectives. #J-18808-Ljbffr GE Appliances
- ...Director also provides oversight and coordination of all insurance claims and manages the Company’s Third Party Claims administrator.... ...solving skills, including interpreting complex data and making strategic decisions.* Leadership: Proven ability to lead cross-functional...ClaimsWork at officeFlexible hours
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