RCM QA Lead: Claims & Charge Posting

Eye Care Partners Career Opportunities; Minnesota; On-site; USD 85,000 - 110,000; Full time

Job summary

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to lead QA across charge posting and claims management for multiple practices. You will supervise internal and offshore teams, audit submissions, and drive data-driven improvements to ensure compliance with payer guidelines and regulatory requirements.

The role emphasizes QA auditing, reporting, and training to uphold high standards in RCM workflows, with a focus on CPT/ICD-10 coding accuracy and HIPAA compliance.

Qualifications

• 3+ years of experience in charge posting and/or claims submission and reconciliation.
• Preferred: 1–2 years in a supervisory and/or QA-focused role.
• Strong knowledge of CPT, ICD-10, and HCPCS coding and claims submission workflows.
• Proficiency with billing platforms, clearinghouses, and EHR/PMS systems (e.g., NextGen, Waystar).

Responsibilities

• Supervise day-to-day operations of charge posting and claims production teams, including 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 errors.
• Track, analyze, and report trends in errors and rejections to leadership.
• Create dashboards with PowerBI and other tools for QA metrics.
• Coordinate with managers to address training gaps and process improvements.
• Maintain QA procedures and SOPs aligned with billing guidelines.
• Ensure HIPAA and regulatory compliance across operations.

Skills

CPT/HCPCS coding

ICD-10 coding

QA auditing

Data analysis

Advanced Excel

HIPAA knowledge

English communication

Leadership

Regulatory compliance

Tools

NextGen

Waystar

Excel

PowerPoint

Outlook

Job description

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to lead QA across charge posting and claims management for multiple practices. You will supervise internal and offshore teams, audit submissions, and drive data-driven improvements to ensure compliance with payer guidelines and regulatory requirements.

The role emphasizes QA auditing, reporting, and training to uphold high standards in RCM workflows, with a focus on CPT/ICD-10 coding accuracy and HIPAA compliance.