Auditor UM

ABOUT THIS POSITION

Plans, designs, develops and performs quality assessments on data elements and structures to document and evaluate integrity, completeness, quality, and appropriateness of formats, records and structures. Configures, operates and develops manual and/or automated methods, processes and procedures to test output or input based on data compliance, quality and use requirements as established by product management, client specifications, and governance programs. Performs regular and ad hoc reviews, audits, and investigations of data activity and integrity; prepares reports and summaries of findings. Produces and updates guidelines and documentation of test development processes, procedures and standards.

WHAT YOU'LL DO

What you’ll do:

Client Education and Success:

● Complete record reviews on client records to identify best practice process improvement opportunities

● Complete data analysis of reviews completed and create summary presentations for internal and external communication of record review results

● Engage with client utilization management teams and provide feedback regarding record review and education associated with identified opportunities for best practice improvement

● Develop and provide education regarding clinical concepts to clients and internal stakeholders and product designers

Product Innovation:

● Participate in product performance audits and communicate results with product team

● Perform medical record review to support product innovation and development ● Audit performance of key data science conditions and elements

WHAT YOU'LL NEED

What we’d love to see:

● Bachelor’s Degree or equivalent in Nursing (RN)

● 5+ years of experience in utilization management and/or clinical documentation and auditing clinical documentation

● Self-starter, who is extremely motivated to demonstrate success

● Attention to detail, highly organized, with an absolute focus on quality of work

● Team player DNA with a desire to solve for the interests of our clients and of our business

WAYSTAR PERKS

• Competitive total rewards (base salary + bonus, if applicable)
• Customizable benefits package (3 medical plans with Health Saving Account company match)
• We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid 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

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.