NSA Closure Specialist

Job Type

Full-time

Description

Why you’ll want to work at nimble!

Looking for a seat at the table? 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. As an Implementation Manager, you’ll have the opportunity to work as part of an experienced and agile team of RCM professionals and with cross functional partners, with significant runway to define what success and the future of Implementation at nimble looks like.

Who we are:

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 who trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.

The NSA Closure Specialist is responsible for monitoring and analyzing IDRE selections, payer void requests, and post-determination activities associated with the Federal Independent Dispute Resolution (IDR) process. This role evaluates payer and IDRE trends, develops data-driven IDRE selection recommendations, manages responses to post-determination inquiries, and tracks selection outcomes to improve future decision-making. The position also supports the development of SOPs, reporting, and client-facing deliverables that create repeatable and scalable processes while identifying opportunities to enhance operational capabilities, reporting, and overall dispute resolution performance.

Monitoring and Analysis:

• Monitor IDRE selections and track IDRE selection outcomes
• Review the IDRE selections inbox to identify trends and recurring issues
• Review IDR and selection reports and surface findings
• Maintain and analyze payer-specific and IDRE-specific performance metrics
• Identify emerging payer objection trends and recommend proactive mitigation strategies
  
  
  

Payer Void Requests:

• Analyze payer void requests made after a determination
• Draft and submit well-supported responses to payer inquiries
• Escalate novel or high-risk requests per defined thresholds
• Help develop the SOP for void request responses and escalations
• Maintain the void request management folder
  
  
  

Selections and Recommendations:

• Recommend IDRE selections based on company data, with documented rationale
• Use selection outcomes to refine future recommendations
• Maintain documentation supporting IDRE selection methodologies and recommendations
• Assist in the development and refinement of IDRE selection criteria based on historical outcomes and available data
  
  
  

Gap Identification:

• Identify gaps in selection capabilities and reporting, from both a company and client standpoint
• Document findings and propose improvements
  
  
  

Communication, Data, and Compliance:

• Communicate with payers and IDREs on routine selection and void matters
• Run data quality checks on selection outcome data
• Evaluate current workflows, reporting capabilities, and escalation pathways for operational inefficiencies
• Collaborate with leadership to develop solutions for identified process or reporting gaps
  
  
  

Reporting:

• Develop client-facing reports and produce them on a recurring schedule
• Monitor client input on reporting needs and turn into report requirements
• Run KPI reports and develop trend summaries
• Report trends and outcomes to leadership as needed
  
  
  

Requirements

• 2 years prior experience in healthcare claims processing, medical billing, or related fields
• 2 years prior experience in a firm that is directly involved in the NSA IDR process
• Strong working knowledge of Federal No Surprise Act
• Strong analytical skills with a high level of accuracy and attention to detail
• Ability to manage multiple priorities and a high-volume workload
• Ability to learn various software platforms and navigate
• Excellent written and verbal communication skills
• Proficiency in Microsoft Office applications, particularly Excel and Outlook
  
  
  

Skills:

• High attention to detail and accuracy in data entry.
• Strong organizational and communication skills.
• Ability to meet daily productivity targets in a fast-paced, remote, or production-based environment
• Working knowledge of HIPAA and healthcare data privacy standards
  
  
  

Work Environment

• Remote, depending on client requirements
• Fast-paced, metric-driven production environment
• Requires extended periods of computer use and data entry