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.
Position Overview
Tempus is seeking a Revenue Cycle Manager with a strong focus on denials, appeals, and refunds to lead our dynamic team. This critical role encompasses the management of denials and appeals both pre-payment and post payment. Additionally the role will be responsible for the development of refund policies, assistance with payer audits and general payer relations. The ideal candidate will possess a background in revenue cycle management, with strong focus on denials research, appeal preparations I and communication. A strategic mindset and robust leadership skills are essential for driving process optimization and ensuring compliance with payer requirements.
Key Responsibilities
Denials & Appeals
- Oversee the Tempus denials and appeals team and process to ensure timely and effective resolution of denied claims.
- Analyze denial trends and root cause to develop strategies for reducing future denials.
- Monitor appeal outcomes and track success rates to inform process improvements.
- Collaborate with payers, providers, and internal teams to resolve complex denial issues.
- Train and support staff on denial management and appeal best practices.
- Ensure compliance with regulatory requirements and payer guidelines.
- Prepare and present reports on denial and appeal metrics to leadership.
- Identify opportunities for process optimization and automation within the denials and appeals workflow.
Post Payment Appeals, Refunds & Audits
- Manage the Tempus refunds and post-payment appeals team with a focus on continuous improvement and excellence.
- Develop and implement robust policies and procedures to ensure timely and accurate issuance of refunds where appropriate.
- Establish and monitor Key Performance Indicators (KPIs) to enhance process efficiency.
- Create and maintain Standard Operating Procedures (SOPs) to ensure compliance with all regulatory guidelines and payer requirements.
- Provide comprehensive feedback to management on trends, findings, and strategies for resolving issues with payers.
- Lead initiatives to identify root causes of overpayments and implement proactive measures to reduce future refunds.
- Oversee the collection and organization of all necessary documentation for payer audits, ensuring meticulous documentation management.
- Conduct thorough research to support audit responses and appeals.
- Work closely with relevant departments to address audit findings and implement corrective actions.
Requirements
- Bachelor's degree in healthcare administration, business, or a related field (or equivalent experience).
- Familiarity with healthcare reimbursement, payer policies, and regulatory compliance in the revenue cycle.
- Excellent written communication skills, with the ability to produce clear, concise, and persuasive documents..
- Strong attention to detail and the ability to prioritize multiple competing tasks across projects, Third Party Billing Vendor, and internal Tempus teams.
- Proven track record of establishing and monitoring KPIs and SOPs within a revenue cycle context.
- Creative mindset in order to problem solve, comfort with ambiguity, and confidence to ask key questions.
- Ability to develop and maintain strong relationships across departments (Market Access, Finance, Legal, Product, Medical Affairs, Lab Ops, etc.).
$80,000 - $100,000
The expected salary range above is applicable if the role is performed from Illinois and may vary for other locations (California, Colorado, New York). Actual salary may vary based on qualifications and experience. Tempus offers a full range of benefits, which may include incentive compensation, restricted stock units, medical and other benefits depending on the position.
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.