EverHealth - RCM Quality Analyst (Remote US)

EverCommerce [Nasdaq: EVCM] is a leading service commerce platform, providing vertically tailored, integrated SaaS solutions that help more than 600,000 global service-based businesses accelerate growth, streamline operations, and increase retention. Our modern digital and mobile applications create predictable, informed, and convenient experiences between customers and their service professionals. Specializing in Home & Field Services and Health Services, EverCommerce solutions include end-to-end business management software, embedded payment acceptance, marketing technology, and customer engagement applications. We are building an extraordinary company and looking for talented, energetic, and motivated people to join our team. You can learn more about our Company, Culture and Values here: https://www.evercommerce.com/about-us/careers/

We are seeking a highly motivated and detail-oriented Quality Analyst to join our Revenue Cycle Management (RCM) Operations team at EverHealth. This role is responsible for monitoring, evaluating, and ensuring the quality of revenue cycle operations performed by external vendor partners and is integral to ensuring the accuracy, compliance, and efficiency of our healthcare billing processes. The ideal candidate will have a strong background in healthcare billing, with demonstrated expertise in reviewing and auditing claims. A commitment to excellence and the ability to create and refine standard operating procedures (SOPs) are essential.  The analyst will collaborate closely with both internal RCM leadership and vendor management teams to drive continuous improvement, accuracy, and efficiency in billing, collections, and related revenue cycle processes.

Responsibilities

Claims Review and Audit

• Conduct thorough audits of vendor-performed RCM functions (coding, billing, payment posting, denials, collections, etc.) to ensure accuracy, compliance with payer requirements, and adherence to industry standards
• Identify and address errors or discrepancies in coding, billing, and documentation
• Provide actionable feedback to billing teams to enhance accuracy and reduce claim denials

Quality Assurance

• Evaluate vendor adherence to established Key Performance Indicators (KPIs), Service Level Agreements (SLAs), and compliance requirements.
• Develop, implement, and refine quality monitoring tools, quality control measures, and audit templates to ensure compliance with organizational and regulatory standards
• Participate in regular billing quality reviews, reporting findings and recommendations to vendor and EverHealth management clearly and effectively

Standard Operating Procedures (SOPs)

• Draft, update, and maintain SOPs for billing, coding, and quality assurance processes
• Collaborate with cross-functional teams to ensure SOPs are current, effective, and user-friendly
• Drive direct improvement in operational metrics through SOP optimization

Compliance and Education

• Stay informed about industry trends, regulatory changes, and best practices in healthcare billing and coding
• Ensure adherence to HIPAA and other applicable regulations
• Escalate quality or compliance concerns to RCM leadership and collaborate on remediation plans

Experience and skills we’re seeking:

• College degree in Healthcare Administration, Business, Finance, or related field (or equivalent work experience) preferred
• Certification in medical billing or coding (e.g., CPC, CCS, or equivalent) strongly preferred
• Minimum of 3 years of experience in healthcare billing, including claims auditing
• Prior experience auditing or overseeing outsourced/vendor-performed RCM work strongly preferred
• Proven experience in writing and maintaining healthcare billing SOPs
• Familiarity with EHR systems and billing software (Drchrono/iSalus a plus)
• Strong analytical skills and attention to detail
• Excellent verbal and written communication abilities
• Ability to work independently and as part of a collaborative team
• Proficiency in Microsoft Office Suite, particularly Excel and Word
• Self-motivated with ability to manage multiple audits/projects simultaneously and thrive in remote work environment

Where:
The EverCommerce team is distributed globally, with teams in the U.S., Canada, the U.K., Jordan, New Zealand, and Australia. With a widely distributed team, we are used to working remotely across different time zones. This role can be based anywhere in the United States – if you’re close to one of our offices, we can set you up in-office or you can work 100% remotely. Please note that you must be eligible to work without sponsorship to qualify for this position, and this role may require travel to our Corporate Headquarters in Denver, Colorado, or to other office locations around North America.

Benefits and Perks:

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Compensation: The target base compensation for this position is $55000 to $65000 USD per year in most US locations. Final offer amounts are determined by multiple factors including location, local market variances, and candidate experience and expertise, and may vary from the amounts listed above