RCM Operations Analyst

Cartwheel•Cambridge, MA

1d•Remote

About The Position

Join 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 intervention, Higher student and family engagement in care, Better coordination among the trusted adults in a student’s life. Kids 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 ROLE We 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.

Requirements

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

Nice To Haves

Experience with SQL for querying claim or eligibility data directly
Background in behavioral health, telehealth, or school-based care billing
Experience building SOPs or operational process documentation in a scaling or startup environment
Familiarity with Apero or comparable RCM and practice management platforms

Responsibilities

Conduct structured analysis of denial and rejection data to identify root causes, payer patterns, and filing limit exposure
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
Iterate on dashboard design and reporting infrastructure based on stakeholder feedback and evolving operational priorities
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