Note: The job is a remote job and is open to candidates in USA. iRhythm Technologies, Inc. is a leading digital healthcare company focused on delivering innovative cardiac health solutions. They are seeking an experienced RCM Process & Quality Analyst Lead to support operational excellence across their revenue cycle, emphasizing process improvement, quality assurance, and compliance.
Responsibilities
- 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
- Lead 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 design, 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 cross-functional initiatives and special projects across RCM QA, compliance, and operational transformation
- Perform additional duties as assigned to support departmental and organizational goals
Skills
- 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
- 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
- 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)
- 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
Company Overview
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