RCM/ OPH Quality Assurance Supervisor

About this role

EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit www.eyecare-partners.com.

Job Title: Quality Assurance Supervisor- Claims

MUST LIVE IN ONE OF OUR 18 States: Missouri, Florida, Kansas, Kentucky, Pennsylvania, Virginia, New Jersey, Texas, Minnesota, Michigan, Oklahoma, Alabama, North Carolina, Georgia, Illinois, Ohio, Indiana, Arizona

Job Summary

The Supervisor for RCM QA Charge Posting & Claims is responsible for overseeing quality assurance and performance across charge entry and claims management functions for multiple practices. This includes direct supervision of internal teams, oversight of co-sourced staff, ownership of QA auditing, workflow optimization, and process standardization. The Supervisor acts as a critical liaison between production teams and leadership, using data-driven insights to improve outcomes and ensure compliance with departmental standards, payer guidelines, and regulatory requirements.

Duties and 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 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.

· Participate in weekly syncs with management to align QA findings with training strategy and offshore coaching plans.

· Maintain and update QA procedures, standard operating 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.

· Encourage cross-functional communication and support the transition to a more standardized and functional model across RCM.

· Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.

· Performs other duties that may be necessary or in the best interest of the organization.

Experience Requirements

· 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

Knowledge, Skills and Abilities Requirements

· Strong knowledge of CPT, ICD-10, and HCPCS coding and claims submission workflows

· Proficiency with billing platforms, clearinghouses, and EHR/PMS systems (e.g., NextGen, Waystar)

· Detail oriented, professional attitude, reliable

· 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

· Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to

· Avoid mistakes or misinterpretations

· Interpersonal skills to support customer service, functional, and teammate support needs

o Able to communicate effectively in English, both verbally and in writing

o Ability to effectively engage and present to diverse audiences at all levels in the organization

o Capable of building strong cross-functional relationships and leading with influence

· Ability for basic to intermediate problem solving, including mathematics

· Intermediate to advanced computer operation

o Advanced skills with Microsoft Excel, Word, PowerPoint and Outlook

· Specialty knowledge of systems relating to job function

o HER/PMS Platforms (e.g. NextGen, Waystar)

o Other Quality Assurance Tools

· Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

· Knowledge of payer guidelines, compliance requirements and HIPAA regulations

Supervisory Responsibilities:

· 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

For remote team members, HIPAA compliant home office environment. Ability to work in a remote environment while performing required duties and remaining patient focused. Able to work varying shifts including early mornings/evenings to attend meetings and cross training or support other initiatives.

If you need assistance with this application, please contact (636) 227-2600

Please do not contact the office directly – only resumes submitted through this website will be considered.

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be…