Nymbl Systems

While working in the IT field, a client in the orthotics and prosthetics industry asked Josh Lau, a 2012 graduate of the University of Kentucky’s biology program, to help find new software for its company.. One of the firms Lau spoke with put him in contact with a physician who was working on his own tech startup, and he then put Lau in contact with Gordon Garrett, associate director of the Kentucky Small Business Development Center and himself, a tech entrepreneur.. We are seeking a skilled and detail-oriented individual to join our team as an HME/DME Medical AR Specialist.. Review and analyze patient medical records, HME, DME, and O&P prescriptions, and supporting documentation to ensure appropriate coding and billing.. Strong knowledge of medical billing and coding practices, including CPT, HCPCS, and ICD-10 coding systems.

accounts receivable specialist

Nymbl Systems is an industry-leading Prosthetics and Orthotics Practice Management software suite. Our mission is to empower healthcare providers with intelligent software solutions. Our StoryWhile working in the IT field, a client in the orthotics and prosthetics industry asked Josh Lau, a 2012 graduate of the University of Kentucky’s biology program, to help find new software for its company. Lau searched for months to meet his client’s needs and found nothing to fit the exceptionally specialized field, propelling him to talk with other orthotics and prosthetics providers to get a strong understanding of the software needs of the field. One of the firms Lau spoke with put him in contact with a physician who was working on his own tech startup, and he then put Lau in contact with Gordon Garrett, associate director of the Kentucky Small Business Development Center and himself, a tech entrepreneur. With a honed pitch and the confidence to go out on his own, Lau found the investors he needed for Nymbl Systems, a software service directed toward helping practitioners in the orthotics and prosthetics industries to schedule appointments, keep patient records, and bill out claims. With investment dollars in hand, Lau was able to hire the right team members and Nymbl Systems was up and running. Nymbl started onboarding clients in March 2018 and now has more than 200 different providers of all shapes and sizes using the solutions every day to support their patients’ needs and generate accurate claims. Job Summary: We are seeking a skilled and detail-oriented individual to join our team as an HME/DME Medical AR Specialist. In this role, you will be responsible for reviewing denied and rejected claims and ensuring compliance with relevant regulations and guidelines. You will be responsible for correction and properly resubmitting claims, creating appeals, sending redetermination and reconsideration requests as well as responding to Additional Documentation Requests (ADRs) and Prepayment Reviews. The ideal candidate will have a solid understanding of medical billing procedures, excellent analytical skills, and strong attention to detail. This is a crucial position within our organization, as accurate and timely denial handling directly impacts our revenue cycle and financial stability. This is a remote position with the expectation of regular work hours and the ability to work in a team-oriented environment. Responsibilities:<ul><li>Follow up on unpaid or denied claims, appealing when necessary, and provide necessary documentation to support the claim.</li><li>Process, scrub and submit secondary, tertiary, etc. medical claims for HME, DME, & O&P services provided to patients in compliance with all relevant guidelines, government regulations, and company policies.</li><li>Verify patient insurance coverage and eligibility for O&P services, ensuring accurate information is recorded and maintained.</li><li>Review and analyze patient medical records, HME, DME, and O&P prescriptions, and supporting documentation to ensure appropriate coding and billing.</li><li>Assign appropriate CPT, HCPCs, and ICD-10 codes to accurately reflect the services provided.</li><li>Communicate with healthcare providers, physicians, and insurance companies to resolve billing discrepancies, obtain additional information, and address claim denials or rejections.</li><li>Stay updated on changes in medical billing and coding regulations, guidelines, and insurance requirements.</li><li>Maintain confidentiality of patient information and adhere to HIPAA guidelines.</li><li>Collaborate with the billing team and other departments to ensure accurate and efficient billing processes.</li><li>Provide training and guidance to staff members on O&P billing procedures and regulations.</li><li>Other duties as may be assigned to you from time to time.</li></ul> Candidate Requirements:<ul><li>High school diploma or equivalent; certification or associate degree in medical billing and coding is preferred.</li><li>2+ years of relevant experience handling medical claim denials, appeals, resubmissions, redeterminations, Additional Documentation Requests (ADRs), Prepayment Reviews, etc.</li><li>Experience in Orthotics or Prosthetics is strongly preferred, Home Medical Equipment or Durable Medical Equipment will be considered.</li><li>Strong knowledge of medical billing and coding practices, including CPT, HCPCS, and ICD-10 coding systems.</li><li>Knowledge of insurance guidelines, regulations, and reimbursement policies related to HME, Durible Medical equipment E, Complex Rehab Technologies and O&P services. </li><li>Familiarity with claim submission processes, including electronic claim submission, paper claim submission and coordination of benefits.</li><li>Proficient in using billing software, electronic health records (EHR), and other relevant computer systems.</li><li>Excellent attention to detail, analytical skills, and problem-solving abilities.</li><li>Strong communication skills, both written and verbal, with the ability to effectively interact with healthcare professionals, insurance companies, and patients.</li><li>Ability to work independently and prioritize tasks in a fast-paced environment.</li><li>Suitable work from home environment.</li><li>Knowledge of HIPAA regulations and patient privacy guidelines.</li></ul> Candidate Preferences:<ul><li>Credentialing, enrollment, and accreditation experience would be preferred.</li><li>Understanding of medical terminology and HME, DME, and O&P terminology is highly desirable.</li></ul> *This job description is intended to provide a general overview of the responsibilities and requirements of the position. It is not exhaustive, and additional duties may be assigned as needed.

START NEW SEARCH