Remote QA Supervisor – RCM & Claims

Eye Care Partners Career Opportunities; Arizona; À distance; USD 70 000 - 95 000; Plein temps

Résumé du poste

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

The role requires strong Excel and PowerBI skills, experience with CPT/ICD-10, and the ability to coach teams in a remote environment.

Qualifications

• Minimum 3+ years of experience in charge posting and/or claims submission and reconciliation.
• Supervisory and/or QA-focused experience preferred (1–2 years).
• Strong knowledge of CPT, ICD-10, and HCPCS coding and claims submission workflows.

Responsabilités

• 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; log errors such as CPT/ICD-10 mismatches 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.
• 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.

Connaissances

QA supervision

Leadership

Data analysis

Communication

Outils

PowerBI

Billing platforms

EHR/PMS systems

Description du poste

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

The role requires strong Excel and PowerBI skills, experience with CPT/ICD-10, and the ability to coach teams in a remote environment.