Remote RCM & Claims QA Supervisor - Ophthalmology

Eye Care Partners Career Opportunities; Lake Michigan Beach (MI); Remote; USD 75,000 - 110,000; Full time

Job summary

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to oversee charge posting and claims QA across practices. The role drives QA audits, process improvements, and compliance with payer guidelines and HIPAA.

You will lead internal and offshore teams, build dashboards in PowerBI, and report trends to leadership. Responsibilities include coaching, training, and ensuring accurate documentation while maintaining high service quality.

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 submission workflows.
• 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, accuracy, and timely processing.
• Perform routine QA audits with an initial 10-15% sample rate, logging errors 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 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 with accurate documentation.

Skills

CPT coding

ICD-10 coding

HCPCS coding

Excel

Regulatory compliance

Tools

PowerBI

EHR/PMS systems

Billing platforms

Job description

EyeCare Partners is seeking a Quality Assurance Supervisor- Claims to oversee charge posting and claims QA across practices. The role drives QA audits, process improvements, and compliance with payer guidelines and HIPAA.

You will lead internal and offshore teams, build dashboards in PowerBI, and report trends to leadership. Responsibilities include coaching, training, and ensuring accurate documentation while maintaining high service quality.