Responsibilities
- Audit claims and drive strategy — Review claims for accuracy of action taken, validate next-best-action decisions, and translate findings into systemic recommendations. You're not fixing one claim; you're identifying the pattern behind it.
- Turn denial data into actionable workflows — Translate denial patterns into root causes and resolution pathways. Define standardized recovery strategies, escalation logic, and decision frameworks that hold up against real-world payer behavior.
- Codify RCM knowledge at scale — Build and maintain the SOPs, specialty guides, and decision frameworks that allow the organization to execute at a high RCM standard without you in every room. You are building a system, not just answering questions.
- Set every new customer up for success — Analyze denial rates, aging, payer mix, and workflow gaps at onboarding. Deliver a data-backed strategic action plan to the RCSM so every account starts with a clear path forward.
- Enable the organization — Support new hire onboarding, partner with Product and Engineering on feature release training, and communicate industry changes with a clear summary of what they mean for each team.
- Shape what gets built — Serve as the embedded RCM SME throughout the product development process. Contribute to PRDs, surface edge cases before build, and hold yourself accountable for the RCM quality of what ships — not just the feedback you submitted.
- Power the sales motion — Provide pre-sales RCM analysis for deals within ICP, create specialty-specific enablement materials for AEs, and review outbound copy for accuracy and appropriate framing.
- Be the expert in the room on escalations — Partner with RCSMs on complex customer challenges, step in when root cause is unclear, and feed systemic insights back into the product roadmap and operational workflows.
Requirements
- 8+ years in Revenue Cycle Management with deep expertise in denials, AR follow-up, and payer behavior
- Hands-on experience analyzing claims data, denial trends, and revenue performance across multiple payers and specialties
- Experience working across functions — you’ve collaborated with Sales, Operations, or Product teams, not just stayed in a billing lane
- Experience designing or improving RCM workflows, SOPs, or decision frameworks — not just executing existing ones
- A track record of using AI tools, automation, or data to work smarter. We expect every member of the CoE to be actively pushing the boundary of what’s possible with the tooling available to them.
Additional Information
- Comprehensive healthcare benefits, unlimited PTO (with a minimum of 10 days off a year), flexibility, and a team that cares about doing this right. We organize regular team off-sites and invest in your professional development.
