RCM Process & Quality Analyst Lead

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iRhythm Technologies, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2006

⚕️ Healthcare Insurance

🧬 Biotechnology

Healthcare Insurance • Biotechnology • Medical Technology

iRhythm Technologies, Inc. is a medical technology company that specializes in digital healthcare solutions for the management of cardiac arrhythmias. The company is best known for its ZioSuite, a comprehensive platform designed to deliver a streamlined solution for assessing heart health through advanced analytics and patient-centered data collection. iRhythm focuses on improving patient outcomes and optimizing the efficiency of healthcare providers through innovative technology in the cardiac monitoring space.

📋 Description

• Lead the design, execution, and continuous improvement of the RCM audit approach • Establish and oversee internal and vendor-facing audit programs • Lead and govern call quality and performance review programs • Develop, standardize, and oversee RCM scorecards, KPIs, and performance frameworks • Own SOX compliance activities, including control design, execution oversight • Serve as a primary point of contact for Internal Audit and Compliance • Lead governance of payer portal access controls, offshore restrictions • Oversee payer contract validation and system configurations • Lead process improvement initiatives, defining future-state workflows

🎯 Requirements

• 5 + years of experience in healthcare revenue cycle or related operational functions • 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. • Bachelor's degree in Healthcare Administration, Health Information Management, Business Administration, Finance, or a related field; or equivalent work experience.

🏖️ Benefits

• Health insurance • Professional development opportunities