Remote QA Supervisor – RCM/OPH Claims

Eye Care Partners Career Opportunities; New Jersey; On-site; USD 70,000 - 90,000; Full time

Job summary

EyeCare Partners seeks a Quality Assurance Supervisor for Claims to oversee charge posting and QA across practices, including offshore resources. You will audit submissions, identify errors, and drive process improvements while mentoring teams and ensuring regulatory compliance.

The role requires strong CPT/ICD-10 knowledge, proficiency with PowerBI, and experience with billing platforms and EHR/PMS systems; excellent communication in English is essential.

Qualifications

• 3+ years of experience in charge posting and/or claims submission and reconciliation.
• Preferred: 1-2 years in supervisory or QA-focused role.
• Strong knowledge of CPT, ICD-10 and HCPCS coding.
• Experience with billing platforms, clearinghouses, and EHR/PMS systems.
• Excellent time management and organizational skills.
• Ability to communicate effectively in English.

Responsibilities

• Supervise day-to-day charge posting and claims readiness teams across internal and offshore resources.
• Review and audit claims submissions, edits, rejections, and charge entry for quality, accuracy, and timely processing.
• Perform QA audits with an initial 10-15% sample rate, logging 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.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Minimum Required: 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., Strong time management and organizational skills to support the leadership of this function)
• Analytical and adaptable to evolving RCM structures and systems
• Skilled in error analysis, root cause investigation, and performance coaching
• Interpersonal skills to support customer service, functional, and teammate support needs
• Able to communicate effectively in English, both verbally and in writing
• Capable of building strong cross-functional relationships and leading with influence
• Intermediate to advanced computer operation
• Advanced skills with Microsoft Excel, Word, PowerPoint and Outlook
• HER/PMS Platforms (e.g. Other Quality Assurance Tools
• Direct supervision of charge posting and claims production staff
• Oversight of QA auditing for on and offshore production teams
• Responsible for audit accuracy, performance coaching, escalation handling, and team development
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees, planning, assigning, and directing work; appraising performance, rewarding and disciplining employees, addressing complaints and resolving problems

Skills

Supervisory leadership

QA auditing

Healthcare billing knowledge

HIPAA compliance

English communication

Tools

PowerBI

Billing platforms

EHR/PMS systems

Job description

EyeCare Partners seeks a Quality Assurance Supervisor for Claims to oversee charge posting and QA across practices, including offshore resources. You will audit submissions, identify errors, and drive process improvements while mentoring teams and ensuring regulatory compliance.

The role requires strong CPT/ICD-10 knowledge, proficiency with PowerBI, and experience with billing platforms and EHR/PMS systems; excellent communication in English is essential.