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About the Role:
- You will own the day-to-day integrity of claims and adjudication workflows, working hands-on with the hardest claims and denials.
- You will build the playbooks, benchmarks, and dashboards that enable claims operations to scale.
Key Responsibilities:
- Review and adjudicate imaging claims against benefit designs and contracted rates, resolving pricing and coding discrepancies.
- Investigate denial root causes, drive appeals, and build analysis to prevent future issues.
- Manage EDI submissions and clearinghouse workflows in Waystar, troubleshooting rejections and payer edits.
Qualifications:
- 4+ years in healthcare claims, revenue cycle, or medical billing with deep experience in EDI and denials.
- Strong command of CPT/HCPCS, ICD-10, and cost-sharing mechanics.
- Advanced spreadsheet skills and comfort building reporting from raw claims data.
OneImaging
OneImaging is a concierge radiology service that connects patients with a network of over 5,000 vetted providers across 48 states, reducing imaging costs by 60-80%. We are a high-growth company building the infrastructure for fair and transparent medical imaging, with a focus on employer and payer ROI.