Reports To: Technical Director of Operations
Department: Authorization & Billing Operations
Position Overview
The VA & Workers’ Compensation Authorization Supervisor is a hybrid role responsible for managing a team of specialists who are responsible for authorizations, claims processing, and payer communications across two distinct lines of business: the Veterans Affairs (VA) Community Care program and Workers’ Compensation (WC) claims. This position plays a critical role in the revenue cycle and operational continuity of NuLife Med LLC, requiring a professional who can navigate multiple regulatory frameworks, build strong relationships with both VA purchasing agents and WC adjusters, and drive accuracy and compliance across all transactions.
This is a high-impact, dual-function role that represents a core pillar of the organization’s growth strategy. The ideal candidate will bring leadership qualities, strategic thinking, and the ability to manage complex workflows.
Key Responsibilities
Oversee Veterans Affairs (VA) — Community Care Authorization
- Perform Request for Service (RFS) status checks on all assigned VA orders and patients to confirm the RFS is on file with the Veterans Community Care VA office.
- Resubmit Requests for Service as deemed appropriate, ensuring documentation accuracy prior to every submission.
- Conduct research and determine corrective actions, routing RFS files appropriately when issues are identified.
- Respond to VA Purchasing Agents’ Requests for Quotes in a timely manner, typically within one hour of receipt.
- Communicate with VA Purchasing Agents to confirm Purchase Order (PO) issuance and the notification method used to inform IOS.
- Verify the accuracy of Purchase Orders received from VA Purchasing Agents, ensuring all DME is covered and that contracted pricing has been correctly applied.
- Maintain a thorough understanding of the VA Community Care process, including CCN protocols and compliance requirements.
- Organize and maintain official Contracted Order records for each VA inquiry, serving as the authoritative file of record.
Oversee Workers’ Compensation — Authorization & Claims Coordination
- Prepare and submit requests for authorization to workers’ compensation adjusters and/or third-party administrators (TPAs).
- Ensure all required documentation is included in each authorization request prior to submission.
- Follow up proactively with adjusters and TPAs to expedite the authorization process and prevent claim delays.
- Build and maintain positive, professional relationships with WC adjusters and TPA contacts.
- Communicate effectively with adjusters and TPAs to provide additional information, clarification, or supporting documentation on claims.
- Maintain accurate and complete records of all WC authorization requests, claim communications, and outcomes.
- Generate internal and external reports on claim status, progress, and final payment resolution.
- Stay current on applicable workers’ compensation laws, regulations, and billing requirements across relevant jurisdictions.
- Ensure compliance with all legal and industry standards in coordination with adjusters, TPAs, and internal leadership.
General Responsibilities
- Assist with inbound and outbound telephone calls professionally, demonstrating a comprehensive understanding of each payer’s requirements.
- Exercise sound judgment and decision-making, taking ownership of actions and outcomes.
- Collaborate effectively with cross-functional teams including billing, clinical, and operations.
- Perform other duties as assigned by the Technical Director of Operations.
Requirements
- Strong organizational skills with the ability to maintain accurate, complete, and audit-ready records across multiple payer types.
- Excellent written and verbal communication skills; ability to interact professionally with VA Purchasing Agents, WC adjusters, TPAs, and internal leadership.
- Demonstrated understanding of HIPAA rules and regulations and commitment to patient confidentiality.
- Self-motivated, achievement-oriented team player with proven ability to manage competing priorities and deadlines.
- Ability to respond promptly to time-sensitive requests from multiple payer sources.
- Strong problem-solving, research, and analytical skills.
- Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Adobe); intermediate level or above.
- Demonstrated skills in project management, negotiation, conflict resolution, and oral/written presentation.
Qualifications
Education
- Bachelor’s degree in Business Administration, Healthcare Administration, Leadership, Management, or a related field strongly preferred.
- Associate’s degree with equivalent combination of directly relevant experience will be considered.
- Coursework or certification in healthcare billing, coding, or compliance is a plus.
Experience
- Minimum 2–3 years of team lead or supervisory experience in healthcare authorizations, medical billing, DME, or a related healthcare administrative role required.
- Prior experience working with Veterans Affairs, the Community Care Network (CCN), or government healthcare programs strongly preferred.
- Proven experience in workers’ compensation with a focus on authorization submissions and adjuster/TPA collaboration.
- Familiarity with Medicare, Tricare, VA, and insurance billing requirements is highly desirable.
- Established relationships with workers’ compensation adjusters and/or TPAs preferred.
- Ability to work independently while collaborating effectively with cross-functional teams.
Leadership & Professional Competencies
- Demonstrates initiative, accountability, and a solutions-focused mindset.
- Ability to mentor peers, support process improvement, and contribute to departmental leadership goals.
- Strong business acumen with the ability to understand the financial and operational impact of authorization decisions.
- Comfortable operating in a fast-paced environment with evolving regulatory requirements.
Pay: $58,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Work Location: Remote
