RCM Process & Quality Analyst Lead

iRhythm Technologies, Inc.

Job Overview

Location

Remote - US

Job Type

Full-time

Full Job Description

📋 Description

• 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.
• Oversee payer contract validation and system configurations, ensuring accuracy across platforms such as Salesforce, ZIO Suite, and vendor systems.
• 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.

🎯 Requirements

• 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.
• 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.

🏖️ Benefits

• Actual compensation may vary depending on job-related factors including knowledge, skills, experience, and work location.
• Estimated Pay Range: $115,000.00 - $149,000.00
• iRhythm provides reasonable accommodations for qualified individuals with disabilities in job application procedures, including those who may have any difficulty using our online system.
• iRhythm is an Equal Opportunity Employer.

Skills & Technologies

Senior

Remote

Degree Required

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iRhythm Technologies, Inc.

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About iRhythm Technologies, Inc.

iRhythm Technologies, Inc. provides FDA-cleared cardiac monitoring solutions that use wearable biosensor technology and cloud-based data analytics to detect arrhythmias. The Zio patch records continuous ECG for up to 14 days, while proprietary algorithms analyze millions of heartbeat data points to generate clinical reports for physicians. The company serves hospitals, clinics, and healthcare systems aiming to improve diagnostic accuracy and reduce stroke risk associated with undiagnosed atrial fibrillation.

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