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

Job Summary

The AR Quality Auditor is responsible for evaluating the quality and accuracy of Accounts Receivable (AR) processes, identifying gaps, and driving continuous improvement across denial management, follow-ups, and resolution workflows. The role ensures adherence to client guidelines, payer protocols, and internal quality standards.

Key Responsibilities

• Perform quality audits on AR workflows including: 
  • Denial management 
  • Insurance follow-ups 
  • Appeals and documentation 
  • Payment posting validation (as applicable) 
• Review accounts worked by AR associates and ensure: 
  • Correct action taken based on payer guidelines 
  • Proper documentation and notes 
  • Accurate claim status interpretation 
• Identify error trends and root causes in: 
  • Denial handling 
  • Underpayment identification 
  • Escalation gaps 
  • Process deviations 
• Provide structured feedback and coaching to AR teams 
• Maintain and publish: 
  • QA scorecards 
  • Audit reports 
  • Weekly/monthly quality dashboards 
• Collaborate with: 
  • Operations teams for process improvement 
  • Training  teams for refresher sessions 
  • Clients  (if required) for quality alignment 
• Ensure compliance with: 
  • HIPAA guidelines 
  • Client SOPs 
  • Internal quality benchmarks 
• Participate in calibration sessions to standardize audit decisions 
• Recommend and drive corrective action plans (CAPA) for low performers 

Eligibility Criteria

• Minimum 4+ years of experience in AR (Accounts Receivable) in US Healthcare RCM 
• Mandatory minimum 1 year experience as a Quality Auditor (AR QA) 
• Strong  understanding of: 
  • Denials(CO, PR, OA codes) 
  • Appeals and reconsiderations 
  • Payer-specific guidelines (Medicare, Medicaid, Commercials) 
  • EOB/ERA analysis 
• Hands-on experience in: 
  • AR calling / account resolution 
  • Working on different billing systems / EMRs 

Skills Required

• Strong analytical and auditing skills 
• Excellent knowledge of AR workflows and denial management 
• Ability to identify patterns and recommend improvements 
• Good communication skills (written & verbal) 
• Proficiency in Excel (reporting, trackers, dashboards) 
• High attention to detail and accuracy 

Preferred Qualifications

• Experience in handling multiple specialties (ASC, Physician Billing, Anesthesia,      etc.) 
• Exposure to quality frameworks (Six Sigma / Lean – good to have) 
• Experience in training or coaching teams 

Success Metrics (What Good Looks Like)

• High audit accuracy and consistency 
• Reduction in repeat errors 
• Improvement  in team quality scores 
• Effective feedback adoption by operations 
• Measurable contribution to process improvements