Senior Quality Assurance Analyst - Claims

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 Senior Quality Assurance Analyst to join our team and play a pivotal role in ensuring the accuracy and completeness of 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 Claims, 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 claims workflows and identify errors, focusing on accuracy, compliance, and process integrity.
• Flag recurring issues and trends to QA leadership, with special emphasis on high-dollar and repetitive errors that drive avoidable refunds.
• Provide clear, concise, and actionable feedback from audit findings to operations and training teams to drive continuous performance improvement.
• Assist in generating weekly audit summaries and trend reports to highlight patterns, root causes, and areas for escalation.
• Collaborate in recall/root cause analysis sessions to determine corrective actions and support next steps for the claims team.

Who you are!?

• Minimum 2–3 years of experience in healthcare revenue cycle management (claims, accounts receivable, or related functions).
• Auditing experience in claims or RCM processes strongly preferred.
• Familiarity with claims workflows, payer rules, and denial management best practices.
• Ability to recognize error patterns, document findings clearly, and escalate recurring issues when required.
• Detail-oriented with strong organizational and written communication skills.
• Experience with RCM systems such as HST, NexGen, eClinicalWorks, or Imagine is considered a plus.

Key Competencies

• Attention to Detail?– Consistently catches discrepancies in claim issues, 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