Senior Quality Analyst

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  

https://www.athenahealth.com/careers/equal-opportunity