Enterprise Rules & Edits Analyst

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 and technology teams to be an expert in government and payer requirements, improving clean claim rates and reducing denials. 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. Study healthcare industry standards and stay up‑to‑date on industry changes and compliance issues, focusing on government/payer requirements for claims billing, coding, and 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. Configure system settings and options; plan and execute unit, integration, and acceptance testing. Serve as subject matter expert in medical billing and coding, authorization rules and requirements, and 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 a healthcare setting. Understanding and knowledge of hospital revenue cycle workflows and provider reimbursement processes from patients and payers, 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. Planning and organization skills to independently develop and lead projects when applicable. Excellent written communication skills; able to succinctly convey complex ideas through writing. Flexibility and agility; able to rapidly adapt to changing situations and inputs. Medical claims coding certification preferred. Benefits Competitive total rewards (base salary + bonus, if applicable). Customizable benefits package (3 medical plans with Health Savings Account company match). Generous paid time off for non‑exempt team members (starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays); flexible time off for exempt team members + 13 paid holidays. Paid parental leave (including maternity and 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. Equal Opportunity Employment 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. Job Category: Client Operations Job Type: Full time Req ID: R3104 #J-18808-Ljbffr Waystar