Remote RCM Claims QA Supervisor

Eye Care Partners Career Opportunities; Guin (AL); À distance; USD 70 000 - 90 000; Plein temps

Résumé du poste

EyeCare Partners Career Opportunities is seeking a Quality Assurance Supervisor- Claims to lead QA across charge posting and claims management for multiple practices. You will supervise teams, audit submissions, and drive process improvements in a HIPAA-compliant environment.

The role emphasizes data-driven oversight, escalation handling, and coaching to improve accuracy and throughput. Strong CPT/ICD-10 coding knowledge and proficiency with PowerBI and billing platforms are essential.

Qualifications

• 3+ years in charge posting and/or claims submission and reconciliation.
• Supervisory or QA experience preferred (1–2 years).

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, 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.
• 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.

Connaissances

CPT/ICD-10/HCPCS coding

Billing platforms & clearinghouses

EHR/PMS systems

PowerBI data reporting

Time management

Analytical skills

Interpersonal communication

English communication

Outils

PowerBI

Description du poste

EyeCare Partners Career Opportunities is seeking a Quality Assurance Supervisor- Claims to lead QA across charge posting and claims management for multiple practices. You will supervise teams, audit submissions, and drive process improvements in a HIPAA-compliant environment.

The role emphasizes data-driven oversight, escalation handling, and coaching to improve accuracy and throughput. Strong CPT/ICD-10 coding knowledge and proficiency with PowerBI and billing platforms are essential.