RCM QA Lead, Claims & Charge Posting

EyeCare Partners

Tyler (TX)

On-site

USD 65,000 - 90,000

Full time

3 days ago

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Job summary

EyeCare Partners in Tyler, TX is seeking a Quality Assurance Supervisor for Claims and RCM QA. You will supervise charge posting and claims readiness teams, audit submissions, and drive QA improvements with data-driven insights.

This role requires 3+ years in charge posting/claims and supervisory experience, plus strong CPT/ICD-10 knowledge and Excel/PowerBI proficiency. You will collaborate with management, provide monthly performance summaries, and ensure adherence to HIPAA and payer

Qualifications

Minimum 3+ years in charge posting and/or claims submission and reconciliation.
Preferred 1-2 years in a supervisory/QA-focused role.
Strong CPT/ICD-10 knowledge and claims submission workflows.
Proficiency with billing platforms, clearinghouses, and EHR/PMS systems.

Responsibilities

Supervise day-to-day operations of charge posting and claims readiness teams across internal and offshore resources.
Review and audit claims submissions, edits, clearinghouse rejections, and charge entry for quality, accuracy, and timely processing.
Perform routine QA audits with a 10–15% sample rate and log errors (CPT/ICD-10 mismatches, modifier issues, payer inaccuracies).
Track and report trends in errors and rejections; provide monthly QA summaries to leadership.
Create dashboards with PowerBI and other tools for site-specific QA metrics.