Vice President, Claims, Front-end Services, and Tasking

Job Type

Full-time

Description

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 over 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.

nimble solutions (“nimble” and f/k/a National Medical) is currently seeking a Vice President, Claims, Front End Services, and Tasking nimble provides revenue cycle outsourcing services to ambulatory surgery centers (“ASCs”), surgical practices, surgical hospitals, and anesthesia groups. This is a great opportunity to join a market-leading brand serving a high-growth end market while gaining valuable experience working closely with leadership.

As the Vice President, Claims, Front End Services, and Tasking, you will oversee, develop, and be accountable for $50 million in client revenue and lead a team of 5-15 direct reports with accountability and oversight for 35 offshore team members and 15 onshore team members. This individual should have a successful track record of driving results to meet performance SLA’s, expertise in RCM claims, and demonstrated ability to lead, develop, grow, and optimize a team and operations. You will be focused on creating a driving strategy, optimizing our operation and resources, and leading workforce planning strategies.

Responsibilities

People Leadership

• Responsible for meeting
• Budget/forecast
• Productivity and 95% or > QA expectations
• Responsible and accountable for the entire Claims, Front End, and Tasking team of 35 offshore team members and 15 onshore team members
• Create OKRs and cascade to Directors, Assistant Directors, and ensure OKRs are implemented, and the team is driving toward measurable results and outcomes
• Holds the team accountable for meeting OKRs
• Drives performance through established department KPIs (key performance indicators) and holds the team accountable
• Ensures Claims and Front End Leadership provides leadership and drives the training plan for new Accounts Receivable team members (in partnership with the training team)
• Ensures the leadership team is developing and coaching underperformers
• Accountable for driving team members to meet and exceed goals and provide detailed feedback to the team and leadership if the goals are not met
  
  
  

Analytics

• Ensure the team is using and analyzing data to create and drive action plans to resolve accounts and issues
• Ensure the team creates and executes reports weekly, monthly, quarterly, etc., and claim reports for clients
  
  
  

Subject Matter Expert

• Acts as a resource for all Accounts Receivable team members for questions regarding billing policies, state guidelines, reimbursement analysis, and assists with the resolution of challenging accounts and claims
  
  
  

Process

• Ensures and holds the team accountable for adhering to policies, procedures, and best practices
• Leads and ensures change management best practices are followed and monitored, and adhered to the adoption of processes
  
  
  

Client Services

• Partners closely with Client Management leadership to proactively identify items that may lead to client risk, maintain/exceed client satisfaction, and address any questions related to claims performance
• Presents account performance to clients and internal leadership, and key stakeholders
• Subject matter expert on client accounts, responsible for oversight
• Accountable for ensuring the client risk SLA is met
  
  
  

Requirements

• At least 7 years of experience in revenue cycle focused on claims, with at least 5 years in a leadership position
• 7 years of Accounts Receivable and Claims experience in the healthcare industry
• Strong analytic skills and proven success leading process improvement initiatives and project management
• Knowledge of Medicare, Medicaid, Private Insurance, Private Pay, Liability, and Worker’s Compensation requirements and procedures, and diagnosis and medical terminology
• Intermediate level of expertise with Microsoft Office Suite
• Knowledge of and ability to comply with HIPAA, HITECH, and patient confidentiality policiesWorkers’
• Advanced knowledge of the revenue cycle is required; experience with ASC billing is preferred
• Epic experience strongly preferred
• Experience creating and delivering client-facing content and client presentations
  
  
  

Key Competencies

Drives Results. Consistently achieves results, even under difficult circumstances. Fosters a sense of urgency in the team for reaching goals and meeting deadlines. Readily acts on challenges, Identifies, and seizes new opportunities; Leads others to persist despite setbacks or obstacles; Establishes clear responsibilities and processes for monitoring work and measuring results.

Communicates Effectively. Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences. Provides timely and helpful information to others across the organization; Encourages the open expression of diverse ideas and opinions; Picks up on situational cues and adapts personal, interpersonal and leadership behavior to fit.

Quality Decision-making. Makes sound decisions, even in the absence of complete information; Considers all relevant factors and uses appropriate decision-making criteria and principles; shows courage in speaking up in driving appropriate decisions for the organization based on sound risk/reward analysis.

Customer Focus. Gains insight into customer needs; Identifies opportunities that benefit the customer; Builds and delivers messaging and solutions that meet customer expectations.

Location

Hybrid position and Chesterfield location. Role requires travel to company offices, key company, and industry events

Start Date

Immediately