RCM Specialist: Appeals & Refunds

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.