RCM Operations Analyst (Remote)

RCM Operations Analyst (Remote)Cambridge, MAJoin Cartwheel to help tackle the student mental health crisis.Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means:Earlier interventionHigher student and family engagement in careBetter coordination among the trusted adults in a student's lifeKids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they're excited to live. If you join Cartwheel, you'll help make this vision a reality for millions of students across the country. We're backed by top investors including Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.About The RoleWe are seeking an experienced RCM Operations Analyst with strong analytical skills, hands-on denial and rejection management experience, and deep knowledge of insurance billing workflows. This role will serve as the operational intelligence layer of Cartwheel's revenue cycle — connecting claim data to workflow problems, surfacing gaps and trends, and building the dashboards, SOPs, and process frameworks that drive measurable improvements in reimbursement outcomes. You will partner closely with the RCM Director and cross-functional teams to translate data findings into actionable operational fixes and build the systems infrastructure to sustain them.Role type: Full Time Salary: $62,000 - 83,000 Location: RemoteWhat You'll DoDenial & Rejection AnalysisConduct structured analysis of denial and rejection data to identify root causes, payer patterns, and filing limit exposureMove beyond rework — trace denial and rejection spikes to upstream workflow, documentation, or submission failures and drive fixes at the sourceBuild and maintain AR aging trend tracking and recoverable revenue opportunity analysisExecute claim corrections, resubmissions, and payer follow-up as a hands-on operational contributorDashboard & ReportingBuild and maintain operational dashboards (Looker preferred) that give RCM leadership real-time visibility into denial volume, payer performance, and AR trendsProduce clear, prioritized findings from claim-level data using pivot tables, formulas, and BI toolingDesign reporting outputs so findings are actionable and accessible to non-billing stakeholders — not just data-literate audiencesIterate on dashboard design and reporting infrastructure based on stakeholder feedback and evolving operational prioritiesProcess Documentation & SOP DevelopmentTranslate billing logic, payer-specific rules, and denial patterns into written, maintainable SOPsBuild operational workflow guides prioritized by highest-volume and highest-denial-rate categories firstEnsure documentation is usable by team members without direct guidance, so operational knowledge scales beyond any one personCross-Functional PartnershipPartner with clinical teams to identify upstream documentation or workflow gaps contributing to denials and rejectionsValidate billing logic and payer requirements in collaboration with RCM leadershipCommunicate findings and recommendations in plain language to non-billing stakeholders including clinical and operations partnersSupport training and internal knowledge base development as the operational RCM subject matter resourceWho You AreQualifications3+ years of hands-on RCM operations experience with direct responsibility for denial management, rejection analysis, and billing workflow improvementStrong analytical skills — ability to extract prioritized, revenue-framed findings from large and complex claim-level datasetsExperience 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 analysisIn-depth knowledge of multiple insurance payer environments — Medicaid MCO experience strongly preferred; commercial payer depth (especially BCBS) also requiredDemonstrated root cause instinct — able to trace denial and rejection patterns to workflow or documentation failures, not just surface-level category identificationProcess improvement mindset with strong cross-functional communication skills and comfort working in a remote, async-first environmentExtra CreditExperience with SQL for querying claim or eligibility data directlyBackground in behavioral health, telehealth, or school-based care billingExperience building SOPs or operational process documentation in a scaling or startup environmentFamiliarity with Apero or comparable RCM and practice management platformsPlease apply even if you don't meet all of the criteria. If your past experience doesn't perfectly match the job description, but you bring other relevant experience or skills, we'd still love to hear from you. You may be a great fit!Why You'll Love CartwheelOur hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you'll have:Competitive cash compensation between $62,000 to $83,000Equity ownership stake in the companyHigh-quality health insurance with a $0 monthly premium option for employeesDental, Vision, and Employer-Sponsored Life Insurance4 weeks of paid PTO (3 weeks any time + 1 week office closure in December)Sick Leave + Holidays401K with 2% employer matchTeam-based culture with mission-driven colleagues who will go to bat for youCartwheel is proud to be an equal opportunity employer. We embrace diverse backgrounds and perspectives and an inclusive work environment. We're committed to equal employment opportunity regardless of race, color, religion, ancestry, national origin, gender, sexual orientation, disability status, or veteran status.We participate in E-Verify. Please be prepared to provide acceptable documentation to verify your identity and work authorizationCartwheel uses AI-assisted tools to support our hiring process. This may include tools that help organize and surface applications for recruiter review, AI-powered candidate communications and scheduling, interview recording and documentation, and an AI chat tool available to candidates during the process. All hiring decisions are made by Cartwheel recruiters and hiring managers. No candidate is selected or eliminated from consideration solely by an automated system. All hiring decisions are made by humans. If you have questions about how AI is used in our process or would like to request an alternative review method, please contact talent@cartwheelcare.org.Note: Please do not contact our Care, Provider, or Patient Services lines regarding job postings or application status. These teams support our patients and families and are not involved in the hiring process. For all recruitment-related questions, please email talent@cartwheelcare.org.