nimble solutions

Medical Billing and Coding

• Provide coding of medical records and any applicable supporting documentation.
• Codes records to assign ICD-10, CPT, and modifiers in accordance with coding guidelines
• Meets quality and productivity standards and deadlines/turnaround times
• Assigns indicated account and claim data attributes as indicated (POS, revenue code, implant pricing)
• Demonstrates thorough understanding of how work impacts the project/end customer
• Recognize, interpret, and evaluate inconsistencies, discrepancies, and inaccuracies in the medical data received, and appropriate alerts and/or queries indicated by the party or supervisor
• Reviews and correctly responds to AR tasks related to pre-claim edits pertaining to coding and post-submission denials
• Demonstrates a good rapport and works to establish cooperative working relationships with all members of the team
• Demonstrates willingness and flexibility in working additional hours or changing hours whenever required between normal business hours

Medical Coder – Spine & Ortho

Director

• Lead the Patient Accounts organization across multiple geographies, including managers, supervisors, customer service representatives, and collection specialists
• Oversee remote workforce operations across U.S., Philippines, and India, ensuring consistent training, communication, performance standards, and quality control
• Develop team structure, hiring plans, productivity models, and workflow assignments that support multi-client needs and call volume distribution
• Establish departmental goals and ensure accountability through performance reviews, KPI management, and effective coaching
• Oversee daily operations of the inbound patient call center, ensuring timely service, accurate resolution, and achievement of service-level agreements (SLAs)
• Manage outbound collection strategies, including call cadence, scripting, quality assurance, and conversion optimization
• Serve as the subject matter expert for call center technology, telephony platforms, QA systems, and dashboards
• Monitor quality, handle escalations, and implement continuous improvement initiatives to enhance patient satisfaction and operational efficiency
• Ensure compliance with all federal, state, and local regulations related to patient billing, communications, and collections, including FDCPA, TCPA, and HIPAA
• Develop and execute strategies to improve patient collections, reduce A/R days, and optimize cash flow
• Implement and monitor payment plan programs and patient outreach initiatives
• Oversee placement of accounts with bad debt agencies; work with the client success team, ensuring client approvals are tracked
• Analyze account activity trends to identify root causes and design corrective strategies
• Oversee relationships with all third-party vendors supporting patient accounts, including call center technology providers, merchant vendors, and bad debt agencies
• Establish clear performance expectations, KPIs, and SLAs for each vendor, ensuring alignment with organizational goals and client requirements
• Conduct routine performance reviews, develop vendor scorecards, and escalate issues when performance gaps are identified
• Implement structured governance routines with vendors, including monthly/quarterly business reviews, action plan follow-ups, and continuous improvement initiatives
• Monitor vendor productivity, response times, service quality, and patient experience metrics to ensure consistent delivery
• Produce comprehensive dashboards and reporting packages highlighting operational performance, collection results, call center metrics, staffing trends, and improvement opportunities
• Use data-driven insights to guide decision-making and recommend operational enhancements
• Track the impact of implemented strategies and regularly evaluate results against client goals and internal benchmarks

Director, Patient Accounts

Accounts Receivable

• Calling payers to understand why insurance claims were denied or paid incorrectly
• Working in multiple practice management systems and other workflow technologies
• Receiving client inquiries and addressing them in a timely manner as they relate to unpaid insurance claims
• Checking payer portals for insurance claim statuses
• Participating in team meetings and client meetings
• Working with leadership to increase client collections i.e., getting additional insurance claims paid
• Learning how to prioritize a work queue for maximum efficiency
• Having fun, building relationships, and contributing towards maintaining positive team morale

Accounts Receivable Representative

• Manage client SLA's
• Responsible for departmental KPI's to ensure targets are achieved
• Manages employee performance management - conducts employee performance evaluations
• Creates & Enforces standard operating procedures across the coding function
• Drives process improvement in coding service delivery
• Collaborates with other RCM functional areas regarding coding needs
• Has the authority and responsibility to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, discipline, direct, or recommend such actions by using independent judgment
• Creates and presents client reports
• Participates in thought leadership - internal and external facing
• Completes monthly business review packages and presents as needed
• Project management - resource planning as per project scope, risk management, and escalation management

Medical Coder – Spine & Ortho

Director, Patient Accounts

Accounts Receivable Representative

Director, Coding