QA - Medical Billing - Refunds /CBR

Full-time Description Why work at nimble? 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! 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. What you’ll be doing! nimble solutions (“nimble” and f/k/a National Medical) is seeking a detail-oriented Quality Assurance Representative to join our team and play a pivotal role in ensuring the accuracy and completeness of accounts receivable (AR) claims for our Ambulatory Surgery Centers (ASCs) and Professional Accounts Receivable operations. As part of a market-leading brand in a high-growth industry, this role offers an exceptional opportunity to work closely with leadership while gaining valuable experience in a dynamic and supportive environment. The primary responsibility of this role is to audit AR claims against an established rubric, ensuring they meet quality and compliance standards. Your expertise will directly impact operational excellence by driving improvements in claims accuracy and supporting a culture of accountability and precision. The ideal candidate will have a proven track record in accounts receivable, revenue cycle management, and auditing. Success in this role requires exceptional attention to detail, strong analytical skills, and the ability to identify patterns and discrepancies in claim processing. You will leverage your expertise to provide actionable feedback to enhance team performance, optimize processes, and ensure compliance with best practices. Join us and contribute to our mission of delivering excellence in healthcare financial management while advancing your career with a company dedicated to growth and innovation.

• Conduct audits of credit balance and refund-related accounts to ensure accuracy, compliance, and proper documentation.
• Identify errors in how our refunds are managed, and any root causes such as payment posting, overpayments, or contract misapplications, and flag recurring issues to QA Leadership.
• Focus audits on high-dollar or repeat credit balances to help reduce avoidable refunds and improve team performance.
• Provide clear, concise feedback through audit findings and contribute to team-level training and process improvements.
• Assist in generating weekly audit summaries and reporting key trends or risks to QA Leaders.

Requirements

Who you are!

• Minimum of 2-3 years of experience in accounts receivable, payment posting or revenue cycle management; auditing experience preferred
• Familiarity with refund workflows, payer rules, and credit balance resolution in a healthcare setting
• Able to recognize patterns, document findings, and escalate recurring issues for review. If required, participate in root cause analysis to determine the next steps for the Refunds team
• Detail-oriented with strong organizational and written communication skills
• Experience with HST, Nextgen, e-clinical works, or Imagine a plus

Key Competencies

• Attention to Detail – Consistently catches discrepancies in refund requests, payment applications, and supporting documentation
• Basic Analytical Thinking – Able to recognize patterns or errors in audit data and summarize them clearly
• Time Management – Meets daily and weekly audit quotas and prioritizes high-impact accounts effectively
• Process Adherence – Follows established audit checklists, SOPs, and compliance protocols without deviation
• Communication of Findings – Clearly documents audit results and provides concise, constructive feedback to QA Leadership
• Data Entry Accuracy - Maintains precision when entering audit outcomes in tracking tools, ensuring accurate reporting
• Confidentiality & Integrity – Handles patient data and financial information with professionalism and in accordance with HIPAA and internal policies

Location Remote position. May require travel to company offices, key company, and industry events Start Date Immediate Apply tot his job Apply To this Job