Overview
Summary
Skills
Work History
Education
Certification
Work Availability
Timeline
47
Dustin Nelson

Dustin Nelson

Revenue Cycle Leader
Denver,Colorado

Overview

10
10

Years of medical billing experience

7
7

Years in leadership

20
20

Million dollar average A/R portfolio

1
1

Email away from being a part of your team.

Summary

Manager of Payer Relations with 10 years of experience working in healthcare, including network management analytics, contract compliance, and revenue operations leadership. Certified Healthcare Financial Professional and Specialist in Managed Care by HFMA. Experienced in managing projects across various departments and maintaining relationships with VP and executive level leaders both internally and with insurance payers.

Skills

  • People & Success Management (9-15 FTEs)
  • Revenue Cycle Best Practices
  • Excel Mastery: Lookups, Pivot Tables, Macros
  • Client & Executive Audience Presentations
  • Epic EMR, Change Healthcare, CMSgov, etc
  • Managed Care Contract Performance
  • Aged A/R Collections
  • Hospital and Professional Claim Billing
  • Specialty Service Lines (infusion, behavioral, etc)

Work History

MANAGER, PAYER RELATIONS

Intermountain Health
09.2021 - Current
  • Managed all payer escalations for revenue issues for the CO and MT region through Joint Operating Committees.
  • Led a team of analysts who monitored contract performance and compliance.
  • Used dashboards and reports to track performance metrics across all contracted payers.
  • Presented findings to senior leadership with detailed action plans and next steps for improvement.
  • Managed payer escalations for all lines of business, including behavioral health.
  • Familiar with contract language for fee for service and value-based products.
  • Engaged in enterprise-wide projects to enhance revenue capture and close leakage issues.
  • Produced various reports to measure cost of contract administration.
  • Used communication skills to maintain positive relationships with payers and internal departments while addressing high-stake financial issues and advocating for physicians and hospitals.

ACCOUNTS RECEIVABLE SUPERVISOR

SCL Health
07.2019 - 09.2021
  • Managed a team of revenue cycle associates responsible for reviewing claim denials, escalating payment issues, and liquidating A/R inventory.
  • Led various initiatives across the department to optimize operational efficiencies and address waste concerns.
  • Handled all Commercial lines of business and MRP, including behavioral health.
  • Total inventory managed over $20M.
  • Tracked all claims with missing or underpayments for LOBs.

PATIENT ACCOUNT LEAD/REP

SCL Health
02.2017 - 06.2019
  • Trained new hires in payer disputes and contract interpretation. Developed best
    practices to maximize collection efficiency from commercial insurance payers.
  • Created calculators in Excel capable of quickly calculating reimbursement based off CMS
    fee schedules and contract language, greatly increasing team productivity.
  • Participated in meetings with contractors to discuss identified trends in payer behavior.
    Helped develop SOPs to improve team processes for denials and timely follow-up as
    well as complex workbooks to monitor collections metrics.
  • Managed support and knowledge for the team as a Lead.

ACCOUNT ADMINISTRATOR

Health Net Health Insurance (Teleperformance)
08.2015 - 11.2017
  • Responsible for training, managing access and system usage for claims and appeals
    teams for health insurance company.
  • Self-driven position requiring initiative to identify issues, formulate solutions, and followthrough.
  • Implemented measures for success and regularly reported results and audit results to
    senior leadership.
  • Managed access and requisitions for 1,000+ employees globally.
  • Handled contingencies in high-pressure settings and communicated with operations
    and IT.
  • Created business cases for budgeting new assets.
  • Maintained compliance with Sarbanes-Oxley (SOX).
  • Used Excel extensively for reporting and analysis.

OPERATIONS SUPERVISOR+SME

Health Net Health Insurance (Teleperformance)
10.2014 - 08.2015
  • Helped stand up a new business venture between Health Net Health Insurance and Teleperformance call centers in Mexico by supporting operations on-site and managing a team of call center specialists
  • Responsible for maintaining KPI’s such as call-time and quality
  • Helped other supervisors with coaching strategies
  • Answered questions for employees on the floor (MBWA)
  • Handled managerial duties including payroll and scheduling.

Education

Associate of Applied Science - CIS Business

Arapahoe Community College
05.2025

HS Diploma -

Lincoln College Prep. Academy
Kansas City
05.2012

Certification

Certified Healthcare Financial Professional (CHFP)
Healthcare Financial Management Association

Certified Specialist in Managed Care (CSMC) Healthcare Financial Management Association

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

MANAGER, PAYER RELATIONS

Intermountain Health
09.2021 - Current

ACCOUNTS RECEIVABLE SUPERVISOR

SCL Health
07.2019 - 09.2021

PATIENT ACCOUNT LEAD/REP

SCL Health
02.2017 - 06.2019

ACCOUNT ADMINISTRATOR

Health Net Health Insurance (Teleperformance)
08.2015 - 11.2017

OPERATIONS SUPERVISOR+SME

Health Net Health Insurance (Teleperformance)
10.2014 - 08.2015

Associate of Applied Science - CIS Business

Arapahoe Community College

HS Diploma -

Lincoln College Prep. Academy

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Dustin NelsonRevenue Cycle Leader