CDI Clinical Performance Auditor

About the Role

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.

Responsibilities

• Produces and updates guidelines and documentation of test processes.
• Completes record reviews on client records to identify best practice process improvement opportunities.
• Performs data analysis of reviews completed and creates summary presentations for internal and external communication of record review results.
• Engages with client utilization management teams and provides feedback regarding record review and education associated with identified opportunities for best practice improvement.
• Develops and provides education regarding clinical concepts to clients and internal stakeholders and product designers.
• Participates in product performance audits and communicates results with the product team.
• Performs medical record review to support product innovation and development.
• Audits performance of key data science conditions and elements.

Requirements

• 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 with a desire to solve for the interests of our clients and business.

About Waystar

Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle. Waystar’s healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers.

Waystar products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans.

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: 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 + 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.