RCM Training and Quality Analyst

Work you'll do

As an RCM Training and Quality Analyst, you will deliver Back End Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider clients.

Participate in the design of the training and QA program, including curriculum structure, quality review criteria, and scoring methodology.

Lead implementation of the program across the operations team, establishing workflows, cadence, and documentation standards.

Maintain and refine training and QA materials to reflect updated SOPs, payer requirements, and process changes.

Monitor payer guidelines and requirements on an ongoing basis to incorporate into SOPs and workflows and educate production team on updated guidelines and requirements.

Train onboarding new staff on account and claim processing procedures, systems, and SOPs.

Design and deliver ongoing refresher training for tenured staff to reinforce standards, incorporate changes to payer or client requirements, and address recurring gaps.

Conduct in-depth quality reviews of staff account and claim processing to measure adherence to SOPs.

Deliver structured feedback to staff based on quality review findings, both individually and at the team level.

Develop and deliver targeted staff education in response to quality review trends and identified skill gaps.

Oversee staff processing of accounts and claims following quality reviews to confirm corrective action is applied.

Monitor productivity reporting at the staff and team level against established productivity and quality targets.

Identify root causes of productivity or quality performance issues using staff monitoring and account sampling.

Develop and deliver targeted (staff-level) and team-wide interventions to address identified performance drivers.

Track the effectiveness of interventions and adjust training and QA approach based on outcomes.

Qualifications

• 3+ years of experience in back end revenue cycle operations, with working knowledge of core functions (claims, denials, follow-up, credits, payment posting).
• 1+ years of experience specifically in training delivery, quality assurance, or performance coaching within an operations environment.
• Highly proficient in Epic HB Resolute Billing, with 2+ years of hands-on experience in this environment.
• Strong analytical skills with the ability to translate quality and productivity data into actionable insights.
• Clear, confident communicator able to deliver constructive feedback and lead training sessions for varied audience sizes.
• Bachelor's degree in information technology, business, healthcare, or a related field; or equivalent experience.