RCM/OPH Claims QA Supervisor (Remote)

Eye Care Partners Career Opportunities; Illinois; Remote; USD 70,000 - 100,000; Full time

Job summary

EyeCare Partners is seeking a Quality Assurance Supervisor for Claims to lead QA across charge posting and claims management for multiple practices. You will supervise teams, audit submissions, and drive process improvements using data insights.

The role requires 3+ years in charge posting/claims, knowledge of CPT/ICD-10, and proficiency with PowerBI, Excel, and billing systems. Remote-friendly, with strong communication and leadership skills, and a focus on HIPAA compliance.

Qualifications

• 3+ years of experience in charge posting and/or claims submission and reconciliation.
• Strong knowledge of CPT, ICD-10, and HCPCS coding and claims submission workflows.
• Experience supervising and coaching QA or related teams.
• Proficiency with billing platforms, clearinghouses, and EHR/PMS systems.
• Ability to communicate effectively in English and build cross-functional relationships.

Responsibilities

• Oversee day-to-day operations of charge posting and claims readiness teams across internal and offshore resources.
• Review and audit claims submissions, edits, rejections, and charge entry for quality and timeliness.
• Perform QA audits with a 10-15% sample rate and log CPT/ICD-10 modifier issues and payer errors.
• Track, analyze, and report trends in errors and rejections; provide monthly QA summaries to leadership.
• Create dashboards using PowerBI and other tools with site-specific QA metrics.
• Coordinate with managers to address training gaps and implement improvements.
• Participate in weekly management syncs to align QA findings with training plans and offshore coaching.
• Maintain and update QA procedures and SOPs aligned with billing guidelines.
• Resolve complex claims and charge issues with accurate documentation and communication.
• Conduct training on billing protocols and regulatory updates, ensuring HIPAA compliance.

Skills

QA supervision

Data analysis

English communication

Cross-functional leadership

HIPAA compliance

Tools

PowerBI

Excel

EHR/PMS systems

Billing platforms

Job description

EyeCare Partners is seeking a Quality Assurance Supervisor for Claims to lead QA across charge posting and claims management for multiple practices. You will supervise teams, audit submissions, and drive process improvements using data insights.

The role requires 3+ years in charge posting/claims, knowledge of CPT/ICD-10, and proficiency with PowerBI, Excel, and billing systems. Remote-friendly, with strong communication and leadership skills, and a focus on HIPAA compliance.