nimble solutions

• Calculate and provide accurate, timely cost estimates for scheduled procedures based on patient insurance, benefits, and historical data • Verify insurance eligibility, benefits, and coverage levels (Medicare, Medicaid, Commercial) to determine patient financial responsibility • Review and provide accurate, timely prior authorization submission for scheduled procedures based on patient insurance, benefits, and clinical data • Communicate directly with patients regarding their estimated financial liability and discuss payment options or financial counseling needs • Secure necessary pre-certifications and authorizations, ensuring all documentation is accurate • Log in and out of multiple systems (including practice management systems) to research and answer patient’s questions, accurately and with detail • When handling incoming, returning or placing outbound calls, adhere to HIPAA privacy regulations • Obtain patient payment information over the phone, process the payment and appropriately note the account • Escalate issues effectively to a supervisor or management for assistance • Responsible for ensuring all client specific protocols are followed during the patient billing cycles • Respond to requests, professionally and promptly, and follow up with outstanding requests in a similar matter

• Develop and execute a strategic territory plan to generate new Payment Recovery and IDR business • Prospect healthcare organizations through outbound calling, email, networking, referrals, conferences, and partner relationships • Build relationships with CFOs, Revenue Cycle Directors, CEOs, Practice Administrators, and physician owners • Conduct consultative discovery meetings to understand reimbursement challenges and identify IDR opportunities • Educate prospects on: o The No Surprises Act o Federal and state IDR processes o Out-of-network reimbursement trends o Revenue recovery opportunities • Present the company’s technology, expertise, and performance in managing IDR cases • Manage opportunities through the CRM, maintaining accurate forecasts and pipeline hygiene • Partner with implementation, legal, operations, and client success teams to ensure smooth client onboarding • Represent the company at healthcare conferences and industry events • Consistently exceed quarterly and annual sales goals

• Handle all incoming calls in a manner that adheres to HIPAA privacy regulations • When returning or placing outbound calls, the same HIPAA privacy regulations must be followed • Log in and out of multiple systems (including practice management systems) to research and answer patients’ questions, accurately and with detail • Obtain patient payment information over the phone, process the payment, and appropriately note the account • Escalate issues effectively to a supervisor or management for assistance • Responsible for ensuring all client-specific protocols are followed during the patient billing cycles • Provide an accurate and thorough analysis of aging, as requested • Review statements to ensure that the information and balance are accurate • Respond to requests professionally and promptly, and follow up with outstanding requests in a similar manner

• The Contract Specialist is responsible for implementing and maintaining nimble’s managed care contracting strategy in a multi-state environment • Manage and maintain accurate files for each pending and executed managed care contract; provide timely network updates to clients • Serve as the external negotiator with payers on behalf of healthcare facilities and individual providers, handling all aspects of outreach, communication, and contracting logistics • Analyze contract terms, reimbursement structures, and financial impact using data models and payer data • Develop clear, actionable recommendations based on your analysis and present findings directly to the provider client • Partner closely with clients to understand their goals and challenges, and tailor negotiation strategies accordingly • Assist in resolving billing or contractual issues with insurance carriers, advocating on the client’s behalf • Evaluate, negotiate, and renegotiate managed care contracts with health plans, hospitals/health systems, IPAs, government programs, and other payers • Load and validate payer contract terms, rates, and fee schedules into client systems with accuracy and consistency • Ensure organized documentation and version control for all contract files and related payer communications • Track and interpret regulatory updates, policy changes, and market trends that may affect client reimbursement • Support additional client projects, including payer escalations, audits, and strategic network decisions

• Manage all aspects of the coding quality program • Monitor QA scores for offshore coding resources • Provide feedback to operations teams • Analyze trends from reviews to identify training needs • Develop and implement client-specific QA plans • Prepare client-facing reports • Collaborate with business units for integrated team approach • Serve as subject matter expert for coding inquiries

• Oversee, develop, and be accountable for $10M-$20M in client revenue • Lead a team of 5-15 individuals • Focus on optimizing operations, partnering with the Vice President, Accounts Receivable to create and drive strategy • Accountable for driving performance through established department KPIs and holding the team accountable • Ensure Assistant Directors/Managers provide leadership and drive training plans for new team members • Develop and coach underperforming team members • Partner with the analytics team to review and analyze reports and data to maximize efficiency • Act as a Subject Matter Expert for Accounts Receivable team members

• 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 • Monitors coding inventory and takes action to balance across coders to maintain TAT • Executes on quality assurance remediation actions as indicated • 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 • Take action to drive client revenue and expense management to hit margin targets as defined through the financial forecasting process

• Manage all aspects of the coding quality program, including development and oversight of standard operating procedures, sampling methodology, scoring, and performance management processes • Monitor QA scores for offshore coding resources by specialty and client, ensuring accuracy and compliance • Provide feedback to operations teams and support the development of corrective action plans based on quality review outcomes • Analyze trends from prospective and retrospective reviews to identify educational needs and guide training initiatives for offshore coding staff • Develop and implement client-specific QA plans, including ongoing monitoring, remediation, and follow-up • Prepare client-facing reports that summarize quality scores, trends, and related action plans • Collaborate with business units to build an integrated team approach that supports both client requirements and coder performance • Serve as subject matter expert for coding inquiries, with expertise in Ambulatory Surgery Centers as well as Professional Fee Services

• Lead the Call Center Operations & 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 • Produce comprehensive dashboards and reporting packages highlighting operational performance, collection results, call center metrics, staffing trends, and improvement opportunities

• 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 • To ensure the security and confidentiality of all clinical data handled, including the safekeeping of all health records • To function as the first point of contact regarding coding issues • To promote the interchange of dialogue between nimble management and coders • To have an active involvement in the development and implementation of current information relevant to medical/surgical coding • To be aware of all statutory and local requirements regarding coding policy changes • Assist with client billing questions in a professional and timely manner • Complete coding queues and AR queries as assigned • Address client concerns in a prompt and professional manner • Participate in task force committees and special projects, as required • Assist with client audits, as needed