Claims Analyst

About the role

OneImaging provides a concierge radiology network and aims to reduce imaging costs for patients, employers, and payers. This role owns the day to day integrity of claims and adjudication workflows, building playbooks, benchmarks, and dashboards to support scalable claims operations.

What you'll do

• Own claims adjudication and QA, validating imaging claims against benefit designs and contracted rates.
• Lead denials management, investigate root causes, and drive appeals and resubmissions.
• Manage EDI and clearinghouse workflows across Waystar, troubleshoot rejections, and coordinate with vendors.
• Ensure cost share and accumulator logic is applied correctly for compliant billing.
• Own accounts receivable and aging, providing real time reporting on outstanding balances.
• Build and maintain dashboards and KPIs from claims data to inform leadership.
• Coordinate with prior authorization, finance, and client facing teams to close the loop across workflow stages.
• Document SOPs, edits, and escalation paths and help train analysts as the team grows.

What they're looking for

• 2+ years in healthcare claims, revenue cycle, or medical billing with complex adjudication experience.
• Hands on experience with EDI transactions (837/835) and a clearinghouse platform, Waystar preferred.
• Strong CPT/HCPCS, ICD-10, place-of-service, and modifier logic knowledge, radiology/imaging preferred.
• Understanding of benefit structures, cost sharing, deductibles, and accumulator/HDHP mechanics.
• Advanced spreadsheet skills and ability to build reporting from raw claims data.
• Meticulous, audit minded approach with ability to trace dollars to sources.

For applicants in Nigeria

• The listing does not specify timezone requirements or pay currency; confirm during interview.
• Remote work is stated; country eligibility is not explicitly defined beyond being remote; verify eligibility during interview.
• The listing does not state whether this is contractor or employee; confirm during interview.