Remote RCM Claims QA Supervisor

Eye Care Partners Career Opportunities; Philadelphia (Philadelphia County); Remote; USD 65,000 - 95,000; Full time

Job summary

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

You will use PowerBI and other tools to monitor QA metrics, train teams, and ensure compliance with HIPAA and billing regulations. Experience in leadership and analytics is essential.

Qualifications

• Minimum 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 workflows.
• Proficiency with billing platforms, clearinghouses, and EHR/PMS systems.
• Excellent time management and organizational skills; data-driven mindset.
• Ability to communicate effectively in English, both verbally and in writing.

Responsibilities

• Supervise day-to-day operations of charge posting and claims readiness teams.
• Review and audit submissions, edits, and rejections for quality and timeliness.
• Perform QA audits with sample rate and log errors such as CPT/ICD-10 mismatches.
• Track, analyze, and report trends in errors; provide monthly QA summaries to leadership.
• Create dashboards with PowerBI for site-specific QA metrics.
• Coordinate with managers to address training gaps and improvements.
• Participate in weekly syncs to align QA findings with strategy and offshore coaching.
• Maintain and update QA procedures and SOPs aligned with billing guidelines.
• Resolve complex claims issues and ensure proper documentation.
• Conduct training on billing protocols and regulatory updates.
• Ensure compliance with HIPAA and all applicable billing regulations.

Skills

3+ years of charge posting/claims QA

supervisory experience

PowerBI proficiency

Excel proficiency

English communication

data analysis

coaching and training

Tools

PowerBI

Billing platforms

Clearinghouses

EHR/PMS systems

Job description

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

You will use PowerBI and other tools to monitor QA metrics, train teams, and ensure compliance with HIPAA and billing regulations. Experience in leadership and analytics is essential.