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
- ...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...ClaimsFull timeLive outLocal areaFlexible hours
- 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
- ...RxBenefits is hiring! We are adding a Strategic Pharmacy Analyst to our growing Business Development team... .../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
- ...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
- Waystar, Inc in Louisville, Kentucky is seeking an Enterprise Rules & Edits Analyst to improve claim billing and coding processes. The role involves collaborating with various teams to deliver timely configurations, analyzing data trends, and optimizing claim edits. Applicants...Claims
- ...each and every day. Job Description: Position Summary and Purpose The Senior Strategic Analyst supports UofL Health's mission-driven academic healthcare enterprise by delivering rigorous analysis, actionable insights, and data-driven recommendations that...Shift 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- ...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
- ...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
$117.6k - $161.7k
Lead, Enterprise Data Governance serves as a dedicated Data Steward responsible for day‑to‑day... ..., reference data, dictionaries, quality rules, ownership, and usage context. Maintain... ...healthcare data domains such as member, provider, claims, clinical, financial, operational,...ClaimsTemporary workRemote work$102.96k - $185.33k
...Risk Adjustment Strategic Manager Location: Virginia, Indiana, Georgia, Tennessee, Connecticut... ...operations and strategic execution of enterprise risk adjustment programs, including... ...both prospective and retrospective, claims, vendor quality, and audits. Develops...ClaimsTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week- ...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
- Waystar, Inc in Louisville, KY, is looking for a Strategic Solutions Analyst to act as a liaison with strategic clients. The analyst will handle inquiries and conduct analytics to enhance client experience. Candidates need a bachelor’s degree and strong client service skills...
- 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
- JobRx, Inc. is seeking a Pharmacy Revenue Cycle Analyst in Louisville, Kentucky. This role ensures optimal revenue capture for pharmacy... ...analyze billing for inpatient and outpatient services, update claims data, and collaborate with various departments to resolve billing...Claims
$50k
...Position: Strategic Insights Analyst Location: Jeffersonville, IN Remote Status: On-Site Job Id: 844 # of Openings: 0 Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value...Full timeTemporary workWork at officeImmediate startRemote workHome office- ...Subrogation Analyst Locations: Wisconsin, Indiana, Kentucky Virtual: This role enables associates to work virtually full-time, with... ...Reviews and evaluates accident or incident reports, individual claims, medical, legal or other documents relating to subrogation....ClaimsFull timeTemporary workWork at officeLocal areaMonday to Friday1 day per week
- ...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
$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- Road & Rail Services is looking for a Market Analyst to enhance our strategic growth by analyzing trends and opportunities in the Rail and Industrial logistics sectors. The ideal candidate will manage business opportunities, conduct market research, and create marketing...
- Responsibilities Assist in resolving billing edits that are holding patient claims from billing, by reviewing medical records and other applicable documentation. Position will serve as liaison between Revenue Integrity and Ancillary Departments regarding revenue and compliance...ClaimsRemote job
$92.12k - $126.66k
Pace Industries, LLC is seeking a Program Planning & Scheduling Analyst III in Louisville, Kentucky. This role is pivotal in developing and maintaining the Integrated Master Schedule (IMS), ensuring that projects align with contractual requirements. The analyst will perform...- 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...
- Planning Demand & Logistics Analyst job at Tri-Arrows Aluminum, Inc.. Louisville, KY. We are NOW accepting applications for Planning... ...shipment and freight cost details. Support Logan Aluminum on freight claims as needed Ad-hoc projects as assigned Import Coil Procurement...ClaimsWork at officeFlexible hours
- ...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
$84.74k - $138.67k
...Actuarial Analyst II Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity... ...risk reporting and forecasting. Calculates monthly claims liability reserves, develops merit rating factors and prepares...ClaimsTemporary workWork experience placementWork at officeLocal areaMonday to Friday2 days per week1 day per week$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 placementRelocation packageMonday to FridayFlexible hoursShift work$21 per hour
...: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims... ...Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and...ClaimsFull timeTemporary workWork experience placementRelocation packageFlexible hoursShift work- ...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
- ...Job Description First Merchants Bank is seeking a Bank Fraud Tools Analytics and Calibrations Analyst to join our team! As part of the External Fraud Working Group’s strategic initiative, this role is designed to centralize and enhance the bank’s use of fraud prevention...Flexible hours
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