Medical Billing Operations VA

1?? Medical Billing Operations VA

Role Purpose

The Medical Billing Operations VA is responsible for day-to-day claim execution and A/R follow-up across all Nurowav clinics. This role ensures that completed patient encounters move cleanly from fulfillment into claims submission and payment.

This is a process-driven execution role, not a decision-making role.

Core Responsibilities
Claim & Charge Management

Monitor completed encounters for billing readiness

Validate CPT, modifiers, and service dates (per SOP)

Submit claims through the integrated RCM platform

Track claim status through payer portals and clearinghouse

Correct claim rejections and resubmit promptly

Accounts Receivable Follow-Up

Perform routine A/R follow-ups by payer

Work unpaid or delayed claims within defined timelines

Document all actions inside the platform

Escalate issues that exceed SOP authority

Metrics This Role Is Accountable For

Claims submitted within SLA

Rejection turnaround time

Aging A/R assigned to role

Clean claim rate (execution accuracy)

Authority Boundaries

Can:

Execute claim-related SOPs

Correct known errors

Contact payers per script

Cannot:

Interpret payer contracts

Change billing strategy

Communicate directly with providers

Required Skills

Medical billing experience (US healthcare)

CPT / ICD familiarity

Payer portal navigation

Excellent attention to detail

Strong written English