Senior Director of RCM Audit

Job Summary

To ensure compliance and financial integrity, the full-time Senior Director of RCM Audit will manage independent audits of Revenue Cycle Management and Remote Patient Monitoring functions, focusing on coding accuracy, claims integrity, and adherence to regulatory requirements in a remote environment.

Key Responsibilities

• Design and execute audit plans for RCM, identifying revenue leakage and ensuring adherence to payer contract terms
• Audit RPM compliance, including enrollment eligibility and billing submissions, to meet CMS and payer requirements
• Lead a small audit team, develop talent, and maintain audit-ready documentation while presenting findings to the VP of Compliance

Required Qualifications

• 7-10 years of experience in healthcare compliance, revenue cycle, or coding audit with strong domain expertise
• Demonstrated independent audit experience separate from compliance program design
• Deep knowledge of CMS billing rules and RPM CPT requirements (99453, 99454, 99457, 99458)
• Familiarity with OIG guidance on effective compliance programs, especially Element 6
• Experience in auditing telehealth or remote monitoring programs is strongly preferred