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Irhythmtech logo

RCM Process & Quality Analyst Lead

Irhythmtech
Posted 3 weeks ago
🇺🇸United States🏠Remote📁Healthcare/Clinical
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Career-defining. Life-changing. At iRhythm, you’ll have the opportunity to grow your skills and your career while impacting the lives of people around the world. iRhythm is shaping a future where everyone, everywhere can access the best possible cardiac health solutions. Every day, we collaborate, create, and constantly reimagine what’s possible. We think big and move fast, driven by our commitment to put patients first and improve lives. We need builders like you. Curious and innovative problem solvers looking for the chance to meaningfully shape the future of cardiac health, our company, and your career About This Role: About this role: Our work environment is fast-paced and collaborative, driven by a passion for delivering innovations that improve the quality of health care and patient experience. We are looking for like-minded individuals to join our team today! Job Description : At iRhythm, we are redefining how cardiac care is delivered through innovative technology and data-driven insights. Our mission is to improve patient outcomes and transform the healthcare experience. We’re looking for an experienced RCM Process & Quality Analyst Lead to join our team and support operational excellence across our end-to-end revenue cycle (order to cash), with a focus on improving processes, quality, and consistency. Repo rting to the Manage r, Reven ue Cyc le , t he RCM Process & Quality Analyst Le ad wi ll be responsible for supporting the audit approach and execution of the end-to-end quality program, with a focus on improving consistency, compliance, and operational performance across the revenue cycle. This role leads audit activities, including escalation and resolution, within established compliance and control frameworks. The Lead partners with Internal Audit, Compliance, and cross-functional stakeholders to support alignment with regulatory requirements, payer expectations, and organizational standards. In addition, this role drives process improvements, supports cross-functional projects, and applies strong judgment across RCM processes and controls to maintain compliance and enable continuous improvement. What You Will Be Doing : Lead the design, execution, and continuous improvement of the RCM audit approach, setting priorities aligned with enterprise risk, compliance requirements, and operational needs. Own end-to-end accountability for quality program effectiveness, including audit outcomes, compliance adherence, and performance improvements . Establish and oversee internal and vendor-facing audit programs, identifying systemic trends, control gaps, and improvement opportunities. Lea d and govern call quality and performance review programs, ensuring consistency, accuracy, and alignment with organizational standards. Develop, standardize, and oversee RCM scorecards, KPIs, and performance frameworks to support data-informed decision-making. Lead in the d esign, implementation and continuous improvement of the SOX control environment, ensuring integrity of the control framework and successful audit outcomes. Own SOX compliance activities, including control design, execution oversight, issue identification, remediation planning, and sustained compliance validation. Serve as a primary point of contact for Internal Audit and Compliance, managing audit readiness, findings, and remediation efforts. Lead governance of payer portal access controls, offshore restrictions, and contractual compliance requirements through structured review processes. Partner cross- functionally with Market Access, Quality, Legal, Compliance, Finance, and Operations to resolve complex issues and ensure alignment with compliance requirements. Oversee payer contract validation and system configurations, ensuring accuracy across platforms such as Salesforce, ZIO Suite, and vendor systems Own and lead process improvement initiatives, defining future-state workflows that enhance efficiency, scalability, and compliance. Lead the development, governance, and continuous improvement of controlled documentation (SOPs, Work Instructions, Quality Control Documents). Provide mentorship, and performance oversight to analysts, establishing quality standards and fostering a culture of accountability and excellence. Resolve high-impact escalations from field sales, commercial leadership, and external partners with sound judgment and authority. Support cr oss-functional initiatives and special projects across RCM QA, compliance, and operational transformation . Perform additional duties as assigned to support departmental and organizational goals. What We Need to See : 5 + years of experience in healthcare revenue cycle or related operational functions , with a focus on quality assurance, audit strategy, and process governance . Demonstrated experience leading enterprise-level audit programs and compliance initiatives, with accountability for outcomes. Strong understanding of LCDs/NCDs, payer contracts, claims adjudication, denial codes, and reimbursement workflows. Demonstrated expertise in SOX compliance within medical billing, including control design, execution, and governance. Proven success in leading cross-functional initiatives, influencing stakeholders, and driving organizational change. Experience interfacing with Internal Audit, Compliance, or external auditors, including ownership of audit outcomes and remediation efforts. Skills: Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, macros, etc.). Experience with CRM systems, especially Salesforce. Strong analytical mindset with the ability to identify patterns, risks, and strategic opportunities in audit data. Exceptional communication and executive-level stakeholder management skills. High degree of independent judgment, accountability, and decision-making authority. Ability to lead in a fast-paced, dynamic, and highly collaborative environment. Education and Certifications : Bachelor’s degree in Healthcare Administration , Health Information Management, Business Administration, Finance, or a related field ; or equivalent work experience . Master ’ s degree (MBA, MHA, MPH or similar ) preferred. Relevant certifications highly desirable: Certified Revenue Cycle Representative (CRCR), Certified Professional in Healthcare Quality (CPHQ), Lean Six Sigma Green/Black Belt, Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) Ways to Stand Out : Ability to navigate complex payer landscapes and networks. Demonstrated experience owning SOX control frameworks and audit strategy at scale. Proven ability to drive enterprise-level compliance and operational performance improvements. Location: Remote - US Actual compensation may vary depending on job-related factors including knowledge, skills, experience, and work location. Estimated Pay Range $115,000.00 - $149,000.00 As a part of our core values, we ensure an inclusive workforce. We welcome and celebrate people of all backgrounds, experiences, skills, and perspectives. iRhythm Technologies, Inc. is an Equal Opportunity Employer. We will consider for employment all qualified applicants with arrest and conviction records in accordance with all applicable laws. iRhythm provides reasonable accommodations for qualified individuals with disabilities in job application procedures, including those who may have any difficulty using our online system. If you need such an accommodation, you may contact us at [email protected] About iRhythm Technologies iRhythm is a leading digital healthcare company that creates trusted solutions that detect, predict, and prevent disease. Combining wearable biosensors and cloud-based data analytics with powerful proprietary algorithms, iRhythm distills data from millions of heartbeats into clinically actionable information. Through a relentless focus on patient care, iRhythm’s vision is to deliver better data, better insights, and better health for all. Make iRhythm your path forward. Zio, the heart monitor that changed the game. There have been instances where individuals not associated with iRhythm have impersonated iRhythm employees pretending to be involved in the iRhythm recruiting process, or created postings for positions that do not exist. Please note that all open positions will always be shown here on the iRhythm Careers page, and all communications regarding the application, interview and hiring process will come from a @irhythmtech.com email address. Please check any communications to be sure they come directly from @irhythmtech.com email address. If you believe you have been the victim of an imposter or want to confirm that the person you are communicating with is legitimate, please contact [email protected]. Written offers of employment will be extended in a formal offer letter from an @irhythmtech.com email address ONLY . For more information, see https://www.ftc.gov/business-guidance/blog/2023/01/taking-ploy-out-employment-scams and https://www.ic3.gov/Media/Y2020/PSA200121

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