Remote QA Lead, RCM/OPH Claims & Charge Posting

Eye Care Partners Career Opportunities; Michigan; Remote; USD 65,000 - 90,000; Full time

Job summary

EyeCare Partners is seeking a qualified Quality Assurance Supervisor for Claims to oversee charge posting and claims readiness teams, including offshore resources. The role emphasizes data-driven QA auditing, process standardization, and regulatory compliance.

The candidate will drive improvements with PowerBI dashboards, mentor staff, and ensure adherence to HIPAA and payer guidelines. Strong CPT/ICD-10 knowledge and advanced MS Office skills are essential.

Qualifications

• Minimum 3+ years in charge posting and/or claims submission and reconciliation.
• Strong CPT, ICD-10, and HCPCS knowledge and claims workflows.
• Proficiency with billing platforms, clearinghouses and EHR/PMS systems.
• Advanced skills with Microsoft Excel, Word, PowerPoint and Outlook.
• Ability to communicate effectively in English.

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 and payer submission inaccuracies.
• Track, analyze, and report trends in errors, edits, and rejections; provide monthly QA summaries to leadership.
• Use PowerBI and other reporting tools to create dashboards with site-specific QA metrics.
• Coordinate with managers to address training issues, identify process gaps, and implement improvements.
• Participate in weekly syncs with management to align QA findings with training strategy.
• Maintain and update QA procedures, SOPs, and documentation aligned with 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.
• Adheres to safety policies and supports a culture of high quality and customer service.
• Minimum Required: 3+ years of experience in charge posting and/or claims submission and reconciliation.
• Preferred: 1-2 years in supervisory/QA role.
• Strong knowledge of CPT, ICD-10, and HCPCS coding and workflows.
• Proficiency with billing platforms, clearinghouses, and EHR/PMS systems.
• Analytical and adaptable to evolving RCM structures.
• Interpersonal skills to support customer service and cross-functional collaboration.
• Advanced skills with Microsoft Excel, Word, PowerPoint and Outlook.

Skills

CPT/ICD-10/HCPCS knowledge

Leadership

Communication

PowerBI

Excel/Office suite

Tools

PowerBI

EHR/PMS systems

Billing platforms & clearinghouses

Job description

EyeCare Partners is seeking a qualified Quality Assurance Supervisor for Claims to oversee charge posting and claims readiness teams, including offshore resources. The role emphasizes data-driven QA auditing, process standardization, and regulatory compliance.

The candidate will drive improvements with PowerBI dashboards, mentor staff, and ensure adherence to HIPAA and payer guidelines. Strong CPT/ICD-10 knowledge and advanced MS Office skills are essential.