Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Role summary: Drive measurable improvements in revenue cycle quality by leading end-to-end quality assurance, denial analysis, and process improvement initiatives. As a Senior Operations Analyst (Quality), you will leverage RCM expertise to identify root causes, reduce rework, and enhance accuracy across AR and denials workflows. You will use data, audits, and statistical insights to strengthen process adherence and drive consistent, high-quality outcomes.
Team summary: The Quality team is responsible for ensuring accuracy, consistency, and continuous improvement. The team partners with Operations, Product Lines, and BPO’s to:
Identify quality gaps
Drive process standardization
Enable scalable, high-quality execution across BPO and internal teams
Essential Job Responsibilities:
Conduct end-to-end quality audits on AR calling and denial workflows to ensure adherence to SOPs and quality standards
Analyze denial trends and quality defects to identify root causes (user, process, system)
Drive corrective and preventive actions (CAPA) to reduce recurring errors and rework
Establish and monitor quality metrics (accuracy, defect rate, rework, first-pass yield)
Partner with Operations and BPO teams to improve process adherence and performance outcomes
Perform deep-dive analyses on escalations and high-impact quality issues
Ensure audit documentation, traceability, and compliance with quality standards
Lead quality calibrations to align on defect definitions, scoring, and expectations
Support workflow and SOP improvements based on audit insights and field feedback
Leverage data and AI-enabled tools (where applicable) to improve audit efficiency and insight generation
Additional Job Responsibilities
Coach and guide teams on quality expectations, error prevention, and best practices
Contribute to training content, job aids, and knowledge management
Participate in governance reviews with stakeholders to present quality trends and actions
Support process improvement initiatives focused on reducing cycle time and improving accuracy
Collaborate with Product/Service teams to close gaps in workflows and documentation
Expected Education & Experience
4–6 years of experience in Healthcare RCM operations, quality, or a related analytical operational role.
Strong experience in denial management and AR workflows - including reviewing denial reasons and driving appropriate next steps.
Proven ability in root cause analysis and driving process improvements
Solid understanding of RCM lifecycle (claims, denials, rework drivers, resolution paths)
Experience with quality frameworks, audit methodologies, and SOP adherence
Strong analytical skills with ability to translate insights into actionable improvements
Effective stakeholder management and communication skills
Familiarity with athenaNet or similar RCM platforms is a plus
About athenahealth
Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.
Our company culture: Our talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.
Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.
What we can do for you:
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.
We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.
In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.
Learn more about our culture and benefits here: athenahealth.com/careers
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