Remote RCM Claims QA Supervisor

Eye Care Partners Career Opportunities; Lexington (KY); Remote; USD 70,000 - 90,000; Full time

Job summary

EyeCare Partners is seeking a Quality Assurance Supervisor for Claims within a nationally distributed team. You will oversee charge posting and claims QA across internal and offshore staff, ensuring accuracy and timely processing, with data-driven audits and KPI reporting.

The role requires 3+ years in charge posting/claims and strong CPT/ICD-10/HCPCS knowledge. Remote-friendly with HIPAA compliance and ongoing training responsibilities.

Qualifications

• Minimum 3+ years of experience in charge posting and/or claims submission.
• Preferred 1-2 years in supervisory or QA-focused role.
• Strong knowledge of CPT, ICD-10, and HCPCS coding.
• Proficiency with billing platforms, clearinghouses, and EHR/PMS systems.

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 and timeliness.
• Perform QA audits with a 10–15% sample rate; log CPT/ICD-10 mismatches and payer issues.
• Track and report trends in errors; provide monthly QA summaries to leadership.
• Create dashboards with Power BI and other reporting tools for QA metrics.
• Coordinate with managers to address training gaps and process improvements.
• Participate in weekly management syncs to align QA findings with training plans.
• Maintain QA procedures, SOPs, and documentation aligned with billing guidelines.
• Resolve complex claims issues with accurate documentation and communication.
• Train teams on billing protocols, entry standards, and regulatory updates.
• Ensure compliance with HIPAA and all billing regulations.

Skills

CPT ICD-10 HCPCS coding

Analytical thinking

Interpersonal skills

English communication

Leadership

Tools

Power BI

Billing platforms

Clearinghouses

EHR/PMS systems

Job description

EyeCare Partners is seeking a Quality Assurance Supervisor for Claims within a nationally distributed team. You will oversee charge posting and claims QA across internal and offshore staff, ensuring accuracy and timely processing, with data-driven audits and KPI reporting.

The role requires 3+ years in charge posting/claims and strong CPT/ICD-10/HCPCS knowledge. Remote-friendly with HIPAA compliance and ongoing training responsibilities.