RCM/ OPH Quality Assurance Supervisor
Core
Oversees quality assurance and performance for charge entry and claims management functions across internal and offshore teams.
Role type
Senior IC RCM QA Supervisor
Builds
Accurate claims submissions and optimized billing workflows for 300+ ophthalmology practices
Domain
Healthcare Revenue Cycle Management (RCM)
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure
Required skills
CPT/ICD-10/HCPCS coding, claims submission workflows, billing platforms, clearinghouses, EHR/PMS systems, PowerBI, error analysis, root cause investigation, performance coaching, HIPAA compliance, federal/state billing regulations
Preferred skills
Supervisory experience, QA-focused role experience
Technologies
PowerBI, NextGen, Waystar, Microsoft Excel, Word, PowerPoint, Outlook
Responsibilities
Supervise charge posting and claims readiness teams, audit claims submissions and charge entry, track and report error trends, create QA dashboards, coordinate training and process improvements, resolve escalated claims issues, ensure regulatory compliance
Seniority
Senior, hands-on IC with supervisory duties