RCM Process Quality Analyst Lead

Job Summary

Driving operational excellence in a fully remote environment, the full-time RCM Process Quality Analyst Lead will manage the audit approach for the revenue cycle, focusing on quality improvement, compliance adherence, and cross-functional collaboration to enhance patient outcomes.

Key responsibilities

• Lead the design and execution of the RCM audit approach, prioritizing compliance and operational needs
• Oversee the effectiveness of the quality program, ensuring adherence to compliance standards and driving performance improvements
• Collaborate with cross-functional teams to resolve complex issues and support continuous process improvement initiatives

Required qualifications

• 5+ years of experience in healthcare revenue cycle or related operational functions with a focus on audit strategy
• Demonstrated experience leading enterprise-level audit programs and compliance initiatives
• Strong understanding of payer contracts, claims adjudication, and reimbursement workflows
• Expertise in SOX compliance within medical billing, including control design and governance
• Bachelor's degree in Healthcare Administration, Business Administration, or a related field; Master's degree preferred