logo inner

RCM Specialist: Appeals & Refunds

TempusChicago, Illinois, United StatesOnsite

Passionate about precision medicine and advancing the healthcare industry?


Recent advancements in underlying technology have finally made it possible for AI to impact clinical care in a meaningful way. Tempus' proprietary platform connects an entire ecosystem of real-world evidence to deliver real-time, actionable insights to physicians, providing critical information about the right treatments for the right patients, at the right time.The Reimbursement team oversees revenue cycle operations and reimbursement strategy for Tempus clinical laboratory testing. The position supports relationships with Tempus’ Managed Care, Sales, Finance, Product, Customer Success, Operations, and Business Intelligence (BI), as well as our third party billing vendor.

Summary


The Revenue Cycle Management Specialist position will have a strong focus on denials, appeals, and refunds management and will play a pivotal role in optimizing revenue cycle operations. This position will be responsible for researching, documenting, and analyzing denial and refund trends, as well as driving initiatives to improve appeal success. This role demands a highly motivated individual with a strong desire to learn and work cross-functionally to achieve team goals and objectives.

Responsibilities


  • Monitor worklists for denials, refunds, and appeals in Tempus’ billing system.
  • Ensure timely submission and follow-up of appeals.
  • Monitor trends in denials, refunds, and appeals using reporting and dashboarding tools.
  • Identify and catalog pertinent payer policies impacting denials, refunds, and appeals.
  • Assist with creating and compiling appeal letters and supporting documentation.
  • Conduct pertinent research and present suggestions for improving revenue cycle management (RCM) KPIs.
  • Review and manage write-off worklists.
  • Handle ad hoc requests and special projects as needed, demonstrating flexibility and adaptability to meet evolving business needs.

Preferred Qualifications & Experience


  • Bachelor's degree in healthcare administration, business, or a related field (or equivalent experience).
  • 2+ years of experience in healthcare denials/refunds/appeals, healthcare consulting, revenue cycle management, healthcare operations, or related fields.
  • Familiarity with healthcare reimbursement, payer policies, and regulatory compliance in the revenue cycle.
  • Experience in Microsoft Excel and other data analysis tools.
  • Detail-oriented with a commitment to accuracy and thoroughness in all tasks.
  • Excellent communication skills, both verbal and written, with the ability to convey complex ideas and analysis results clearly.
  • Proven ability to manage multiple projects simultaneously and prioritize tasks effectively.
  • Motivated self-starter with a proactive approach to problem-solving and driving continuous improvement.

#LI-SH1


#LI-Hybrid


We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.Additionally, for remote roles open to individuals in unincorporated Los Angeles – including remote roles- Tempus reasonably believes that criminal history may have a direct, adverse and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment: engaging positively with customers and other employees; accessing confidential information, including intellectual property, trade secrets, and protected health information; and appropriately handling such information in accordance with legal and ethical standards.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law, including the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Life at Tempus

Tempus helps corporate clients navigate global currency markets by combining unparalleled market insight, competitive rates of exchange and unmatched personalized service. We serve thousands of corporate clients by offering these key differentiated features:
Thrive Here & What We Value1. Collaborative Mindset: The company culture at Tempus emphasizes teamwork and collaboration, as seen through the Sales Representative's focus on cross-functional relationships to achieve work goals.2. Innovation and Technology: Tempus values innovation in genomic data usage and advanced technology implementation for improving patient care.3. Integrity and Trust: The company upholds integrity, respect, and trust as core values in all interactions with clients and colleagues.4. Commitment to Quality Care: A strong focus on delivering critical information about the right treatments at the right time for patients demonstrates a commitment to quality care.5. Salesforce Effectiveness: The company encourages sales force effectiveness, as seen through the emphasis on driving results and promoting a culture of compliance within the organization.6. Cross-functional Collaboration: Tempus fosters collaboration across various teams, including oncology and neuropsychiatry clinician-facing sales teams.7. Equal Opportunity Employer: The company is committed to providing equal opportunities for all employees regardless of their background or identity.8. Advanced Communication Skills: Tempus values strong communication skills, as demonstrated by the Sales Representative's advanced presentation and business acumen.9. Passion for Precision Medicine: A passionate commitment to advancing precision medicine in healthcare is a key aspect of the company culture at Tempus.10. Real-time Insights Delivery: The focus on delivering real-time, actionable insights to physicians highlights the importance of timely and relevant information sharing within the organization.
Your tracker settings

We use cookies and similar methods to recognize visitors and remember their preferences. We also use them to measure ad campaign effectiveness, target ads and analyze site traffic. To learn more about these methods, including how to disable them, view our Cookie Policy or Privacy Policy.

By tapping `Accept`, you consent to the use of these methods by us and third parties. You can always change your tracker preferences by visiting our Cookie Policy.

logo innerThatStartupJob
Discover the best startup and their job positions, all in one place.
Copyright © 2024