Dustin Nelson
Littleton,Colorado
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.
Overview
10
10
years of professional experience
2
2
Certificates
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 City05.2012
Skills
- Team Leadership
- Communication Skills
- Task Management
- Escalation Management
- Meeting Facilitation
- Operations Management
- Training & Development
- MS Excel & Office
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
Certified Healthcare Financial Professional (CHFP)
Healthcare Financial Management Association
Certified Specialist in Managed Care (CSMC)
Healthcare Financial Management Association
Associate of Applied Science - CIS Business
Arapahoe Community College
HS Diploma -
Lincoln College Prep. Academy
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