Senior Director, RCM & RPM Audit

This is a fully remote position, open to applicants in United States.

📋 Description

• Provide autonomous, senior-level audit coverage for Revenue Cycle Management (RCM) and Remote Patient Monitoring (RPM) functions.

• Develop and implement audit plans to assess coding accuracy, claims integrity, and submission quality throughout the billing lifecycle.

• Evaluate RPM enrollment eligibility, patient consent documentation, and program onboarding in accordance with CMS and payer standards.

• Collaborate with billing and RCM operations to initiate corrective actions — articulate findings, oversee follow-up, and ensure remediation.

• Execute the independent auditing and monitoring function mandated by OIG Element 6.

• Build and manage a small audit team (RCM Audit Lead + RPM Compliance & Audit Analyst); establish standards and foster talent development.

• Keep audit-ready documentation that supports a defensible record of monitoring as per OIG Element 6.

• Perform additional duties as assigned.

⛳️ Requirements

• 7–10 years of experience in healthcare compliance, revenue cycle, or coding audit, with robust domain expertise.

• Proven independence — audit experience distinct from compliance program design.

• Extensive knowledge of CMS billing rules and RPM CPT requirements (99453, 99454, 99457, 99458).

• Understanding of OIG guidelines on effective compliance programs (Seven Elements), especially Element 6.

• Experience in auditing telehealth or remote monitoring programs is highly desirable.

• CPC, CHC, CPCO, AHIMA coding credential, or equivalent is a plus.

• Capability to translate audit findings into executive-ready risk summaries — reports that prompt action rather than confusion.

• Comfortable establishing a function from the ground up; a systems thinker who remains composed in uncertain situations.

• High integrity and sound judgment; a low-ego collaborator who works well with Billing, RCM Operations, and Legal.

🏝️ Benefits

• Medical, Dental, and Vision plans

• Flexible Spending/Health Savings Accounts

• Flexible PTO

• 401(k) + Company Match

• Life Insurance, Pet insurance, and more