Revenue Integrity Review Specialist

🕒 June 30

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 47%

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Waystar

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

🔥 Funding within the last year

💰 $709.2M Post-IPO Secondary - Waystar on 2025-09

Healthcare • SaaS • Artificial Intelligence

Waystar is an AI-powered healthcare revenue cycle software company that provides a unified, cloud-based platform to simplify healthcare payments and automate the end-to-end revenue cycle for healthcare providers. Its platform covers financial clearance (eligibility verification, patient estimation, prior authorizations), patient financial care, clinical integrity and revenue capture (charge and DRG anomaly detection), claim and payer payment management, denial recovery, and analytics and reporting, with integrations to EHRs and payer systems. Waystar serves hospitals, health systems, physician and specialty practices, ambulatory surgery centers, and other provider organizations, leveraging agentic, generative, and predictive AI to accelerate reimbursement, reduce denials, and improve financial visibility and patient payment experiences.

📋 Description

• Conduct comprehensive medical record reviews to identify Coding, CDI, Quality, and revenue integrity opportunities • Apply advanced knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG methodology, CDI principles, and clinical validation concepts • Evaluate documentation accuracy, code assignment, and clinical support • Identify documentation accuracy opportunities and develop compliant physician queries when clarification is needed • Ensure review findings and recommendations are accurate, clinically supported, compliant, and aligned with Official Coding Guidelines, AHIMA/ACDIS Query Practice Briefs, regulatory requirements, and customer-specific standards • Achieve established productivity, quality, accuracy, and turnaround time standards while managing a high volume of reviews • Prioritize workload effectively and work independently in a fast-paced production environment • Maintain current knowledge of coding, CDI, reimbursement methodologies, clinical practice standards, and regulatory changes • Deliver high-quality review results that meet customer expectations and organizational performance standards

🎯 Requirements

• BSN, RHIA, RHIT, CCS, CCDS, CDIP, or equivalent healthcare credentials • 3–5 years of experience in inpatient coding, CDI, revenue integrity, auditing, or related healthcare field • Strong knowledge of ICD-10-CM/PCS coding guidelines, CDI practices, MS-DRG assignment, clinical validation, and physician query best practices • Demonstrated ability to achieve productivity, quality, and accuracy standards in a high-volume review environment • Strong analytical, critical thinking, and communication skills • Ability to work independently and manage competing priorities • Preferred: Dual certification (CCDS/CDIP and CCS) or willingness to obtain additional certification • Preferred: Experience reviewing records within healthcare technology platforms, such as Prebill or similar clinical review solutions

🏖️ Benefits

• Competitive total rewards (base salary + bonus, if applicable) • Customizable benefits package with 3 medical plans and Health Saving 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 • 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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