Remote QA Lead RCM Claims & Charge Posting

Eye Care Partners Career Opportunities; Indiana; Remote; USD 70,000 - 95,000; Full time

Job summary

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to oversee QA across charge posting and claims management for multiple practices. You will supervise internal and offshore teams, drive QA auditing, and implement data-driven improvements to ensure compliance with payer guidelines and HIPAA regulations.

The role requires strong CPT/ICD-10 knowledge, advanced Excel and PowerBI skills, and the ability to coach staff while partnering with leadership to align QA with training

Qualifications

• Minimum 3+ years 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.

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 an initial 10–15% sample rate, logging errors such as CPT/ICD-10 mismatches, modifier issues, and payer submission inaccuracies.
• Track, analyze, and report trends in errors, edits, and rejections; provide monthly QA and performance summaries to leadership.
• Use PowerBI and other reporting tools to create dashboards with site-specific and functional QA metrics.
• Coordinate with managers to address systemic training issues, identify process gaps, and implement improvements.
• Participate in weekly syncs with management to align QA findings with training strategy and offshore coaching plans.
• Maintain and update QA procedures, SOPs, and documentation aligned with current billing guidelines.
• Resolve complex or escalated claims and charge issues, ensuring accurate documentation and communication.
• Conduct training for teams on billing protocols, charge entry standards, and regulatory updates.
• Ensure compliance with HIPAA and all federal/state billing regulations.
• Encourage cross-functional communication and support the transition to a more standardized and functional model across RCM.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.

Skills

QA auditing

Leadership

CPT/ICD-10 knowledge

Regulatory compliance

English communication

Education

Bachelor's degree in healthcare administration or related field

Tools

NextGen

Waystar

Billing platforms

Microsoft Excel

PowerBI

Job description

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to oversee QA across charge posting and claims management for multiple practices. You will supervise internal and offshore teams, drive QA auditing, and implement data-driven improvements to ensure compliance with payer guidelines and HIPAA regulations.

The role requires strong CPT/ICD-10 knowledge, advanced Excel and PowerBI skills, and the ability to coach staff while partnering with leadership to align QA with training