RCM Operations Analyst

Cartwheel

RCM Operations Analyst responsible for denial management and billing workflow improvement at Cartwheel. Collaborating with teams to optimize insurance processes for better outcomes.

Posted 5/22/2026full-timeRemote • Massachusetts • 🇺🇸 United StatesMid-LevelSenior💰 $62,000 - $83,000 per yearWebsite

About the role

Key responsibilities & impact

Conduct structured analysis of denial and rejection data to identify root causes, payer patterns, and filing limit exposure
Move beyond rework — trace denial and rejection spikes to upstream workflow, documentation, or submission failures and drive fixes at the source
Build and maintain AR aging trend tracking and recoverable revenue opportunity analysis
Execute claim corrections, resubmissions, and payer follow-up as a hands-on operational contributor
Build and maintain operational dashboards (Looker preferred) that give RCM leadership real-time visibility into denial volume, payer performance, and AR trends
Produce clear, prioritized findings from claim-level data using pivot tables, formulas, and BI tooling
Design reporting outputs so findings are actionable and accessible to non-billing stakeholders — not just data-literate audiences
Translate billing logic, payer-specific rules, and denial patterns into written, maintainable SOPs
Build operational workflow guides prioritized by highest-volume and highest-denial-rate categories first
Ensure documentation is usable by team members without direct guidance, so operational knowledge scales beyond any one person
Partner with clinical teams to identify upstream documentation or workflow gaps contributing to denials and rejections
Validate billing logic and payer requirements in collaboration with RCM leadership
Communicate findings and recommendations in plain language to non-billing stakeholders including clinical and operations partners
Support training and internal knowledge base development as the operational RCM subject matter resource

Requirements

What you’ll need

3+ years of hands-on RCM operations experience with direct responsibility for denial management, rejection analysis, and billing workflow improvement
Strong analytical skills — ability to extract prioritized, revenue-framed findings from large and complex claim-level datasets
Experience building or actively maintaining operational dashboards (Looker preferred; comparable BI tools acceptable)
Proficiency with pivot tables and Excel or Google Sheets for claim data manipulation and analysis
In-depth knowledge of multiple insurance payer environments — Medicaid MCO experience strongly preferred; commercial payer depth (especially BCBS) also required
Demonstrated root cause instinct — able to trace denial and rejection patterns to workflow or documentation failures, not just surface-level category identification
Process improvement mindset with strong cross-functional communication skills and comfort working in a remote, async-first environment

Benefits

Comp & perks

Competitive cash compensation between $62,000 to $83,000
Equity ownership stake in the company
High-quality health insurance with a $0 monthly premium option for employees
Dental, Vision, and Employer-Sponsored Life Insurance
4 weeks of paid PTO (3 weeks any time + 1 week office closure in December)
Sick Leave + Holidays
401K with 2% employer match
Team-based culture with mission-driven colleagues who will go to bat for you

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

RCM operationsdenial managementrejection analysisbilling workflow improvementdata analysisoperational dashboardspivot tablesExcelGoogle Sheetsbilling logic

Soft Skills

analytical skillscommunication skillsprocess improvement mindsetcross-functional collaborationtraining supportdocumentation skillsproblem-solvingattention to detailadaptabilitystakeholder engagement