RCM Process & Quality Analyst Lead

About the 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.

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.
• 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.
• 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.

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.
• Prominent 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.
• A 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

Pay

Estimated Pay Range $115,000.00 - $149,000.00