Revenue Cycle Specialist

Revenue Cycle Specialist

This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building!

Nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.

We are currently seeking a Revenue Cycle Specialist with a great work ethic to manage the revenue cycle process, including pre-submission review, claim submission, and follow-up. Under the direction of the Billing Manager, this role will be instrumental in ensuring timely claim submission, follow-up with payers, and handling billing discrepancies. This position requires well-rounded knowledge of the revenue cycle process while maintaining compliance with industry regulations.

Key Responsibilities:

• Insurance verification, reviewing submitted claims for accuracy and completeness, investigating and resolving claim denials by analyzing documentation and using appropriate CPT and ICD-10 codes
• Working on insurance appeals and correcting claim information, and working closely with providers, coders, and administrative staff to ensure accurate documentation and billing
• Provide timely billing and reimbursement for services while maintaining compliance with industry regulations
• Utilize and navigate through all available portals for claim information
• Responsible for tracking and documenting follow-up activities to ensure completion of work and provide updates regularly
• Navigating the complexities of healthcare billing and insurance systems to optimize revenue flow

Qualifications and Skills Required:

• High School diploma or equivalent
• Minimum 3 years of medical billing experience
• Out-of-network billing experience strongly preferred
• Strong communication and interpersonal skills
• Excellent attention to detail and organizational skills
• Must be flexible and adaptable to various work environments
• Must be computer proficient