VA Insurance & Massage Therapy Billing Specialist

VA Insurance & Massage Therapy Billing Specialist. VA Insurance System Setup and Integration: Guide the clinic to complete registration and credentialing with SAM.gov, CCN (Community Care Network), and TriWest/Optum. Assist in establishing and managing Clearinghouse (Availity/Office Ally, etc.) accounts to ensure smooth claim submissions. Liaise with VA Case Managers to verify patient authorizations and ensure compliance. Billing and Compliance Management: Responsible for submitting, auditing, and tracking VA insurance claims to avoid denials or delays. Ensure proper use of CPT/ICD-10 coding in alignment with authorization letters. Establish claim tracking mechanisms; initiate follow-ups if payments are not received within 30 days. Clinical Service Compliance Support Provide guidance to massage therapists on SOAP note documentation to ensure HIPAA compliance. Review clinical documentation to ensure it meets VA audit and payment standards. Team Training and SOP Development: Train front desk and billing staff on VA insurance billing workflows and system operations. Develop and implement Billing SOPs (Standard Operating Procedures) to ensure independent execution. Create compliance checklists and perform periodic audits and updates. Optimization and Strategic Planning: Analyze claim denials or payment delays and propose improvement strategies. Provide long-term strategic planning for VA-related business to support revenue growth and clinic expansion. Monitor VA policy updates and CCN rule changes to ensure timely operational adjustments. Job Objectives: Ensure the clinic achieves a VA insurance claim compliance rate of over 95%. Reduce claim payment cycles to within 30–45 days. Build a replicable VA insurance billing system to support future multi-location expansion.