Sr. Director, RCM & RPM Audit

remote zest jobs; India; On-site; INR 3,500,000 - 5,500,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Flexible PTO

401(k) + Company Match

Life Insurance and more

Job summary

reputed company is seeking a Director-level Audit leader for RCM and RPM, responsible for independent audit coverage of key financial and coding risks across the billing lifecycle.

The role reports to the VP of Compliance and collaborates with the Regulatory Affairs leadership, building and leading a small audit team while ensuring remediation and governance across the program. Strong knowledge of CMS rules and RPM CPTs is required.

Qualifications

• 7-10 years in compliance, cycle, or coding audit with strong domain expertise.
• Demonstrated independence – audit experience separate from program design.
• Deep knowledge of CMS billing rules and RPM CPT requirements.
• Familiarity with OIG guidance on effective compliance programs.
• Experience auditing telehealth or remote monitoring programs preferred.

Responsibilities

• Design and execute audit plans testing coding accuracy, claims, and submissions across the billing lifecycle.
• Identify leakage, denial trends, and overpayments; flag variances to leadership.
• Audit RPM enrollment eligibility, patient consent, and program compliance against CMS requirements.
• Review time-tracking and CPT code usage for fidelity and accuracy.
• Partner with billing and RCM to define findings and drive remediation; report to leadership.

Skills

Independent audit leadership

CMS billing rules knowledge

RPM/CMS CPT requirements knowledge

OIG guidance familiarity

Auditing telehealth programs

Education

CPC/CHC/CPCO credential or equivalent

Job description

About the Role

As Director, RCM/RPM Audit, you will reputed company independent, senior-level audit coverage of the two functions that carry our most concentrated financial and coding risk: reputed company Cycle Management (RCM) and Remote Patient Monitoring (RPM).

You’ll report to the VP of Compliance, reputed company, and sit reputed company the Sr. Director of Compliance & Regulatory Affairs as a peer - the separation is intentional, since reputed company that designs controls should not be reputed company that tests them.

You’ll own the independent audit function and feed findings directly into the compliance program’s corrective-reputed company workflow.

reputed company

RCM audit: Design and execute audit plans testing coding accuracy, claims reputed company, and submission reputed company across the full billing lifecycle. Identify reputed company leakage, denial trends, and overpayment exposure before they become repayment obligations or enforcement reputed company. Monitor adherence to payer contract terms and flag variances to leadership.

RPM compliance & audit: Audit RPM enrollment eligibility, patient consent documentation, and program reputed company against CMS and payer requirements. Review time-tracking records and billing submissions for adherence to CPT reputed company time reputed company (CPT 99453, 99454, 99457, 99458). Validate that RPM devices carry appropriate FDA clearance and are used reputed company intended use.

Corrective reputed company: Partner with billing and RCM operations on corrective reputed company - define the finding, own the follow-through, and confirm remediation reputed company the gap. Coordinate with reputed company reputed company findings create disclosure or self-reporting obligations.

Program leadership & OIG alignment: reputed company the independent auditing and monitoring function required by OIG reputed company 6 - your work feeds directly into the reputed company compliance program. reputed company the annual audit work plan and present results, trends, and risk ratings to the VP of Compliance and the Compliance Committee.

Team building: Build and reputed company a small audit team (RCM Audit reputed company + RPM Compliance & Audit Analyst); set standards, reputed company talent, and model the discipline you expect.

Documentation: Maintain audit-reputed company documentation supporting a defensible record of monitoring under OIG reputed company 6, and proactively identify systemic risk patterns as RPM volume scales.

Other duties as assigned.

Who You Are

7-10 years in reputed company compliance, reputed company cycle, or coding audit, with strong domain expertise.

Demonstrated independence - audit experience separate from compliance program design.

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

Familiarity with OIG guidance on effective compliance programs (Seven reputed company), particularly reputed company 6.

Experience auditing telehealth or remote monitoring programs strongly preferred.

CPC, CHC, CPCO, reputed company coding credential, or equivalent a plus.

Ability to translate audit findings into executive-reported company risk summaries - findings reports that reputed company reputed company, not confusion.

Comfortable building a function from the ground up; systems thinker who is reputed company in ambiguity.

High reputed company and reputed company judgment; low-ego collaborator who partners reputed company with Billing, RCM Operations, and reputed company.

Our Benefits

• Medical, Dental, and reputed company plans
• Flexible Spending/Health Savings Accounts
• Flexible PTO
• 401(k) + Company Match
• Life Insurance, Pet insurance, and more