RCM Specialist: Appeals & Refunds - job 1 of 2

The RCM Specialist: Appeals & Refunds at Tempus is responsible for managing denials, appeals, and refunds. This includes monitoring worklists in the billing system, ensuring timely submission and follow-up of appeals, and analyzing trends related to denials and refunds using various reporting tools. Additionally, the specialist will work cross-functionally with teams like Managed Care and Operations to enhance overall reimbursement strategy.

To be considered for the RCM Specialist: Appeals & Refunds role at Tempus, applicants should ideally possess a Bachelor's degree in healthcare administration or a related field, along with at least 2 years of relevant experience in healthcare operations, particularly in revenue cycle management or denials and appeals. Familiarity with payer policies and data analysis tools is also advantageous.

Tempus is committed to the continuous professional development of its RCM Specialists. In the Appeals & Refunds role, employees will have opportunities for training on healthcare regulations, payer policies, and revenue cycle best practices. Engaging in cross-departmental collaboration also encourages knowledge sharing and skill enhancement.

Successful RCM Specialists at Tempus possess strong analytical abilities, attention to detail, and excellent communication skills. The role also requires adeptness at managing multiple projects and deadlines, along with a proactive attitude toward problem-solving and continuous improvement in revenue cycle operations.

The work environment at Tempus is collaborative and dynamic, reflecting a strong commitment to innovation in the healthcare sector. As an RCM Specialist: Appeals & Refunds, you'll be part of a diverse team working towards common goals, with flexibility in tasks, opportunities for remote work, and an emphasis on adapting to the evolving needs of the business.

Be prepared to discuss your specific experiences where you managed denials and appeals, including the processes you followed, tools you used, and any improvements you implemented. Highlighting your analytical skills and attention to detail will be key here.

When discussing task prioritization, consider outlining your strategy for assessing project deadlines, urgency, and business impact. Discuss any tools or methods you've used to stay organized and ensure timely completion of all tasks.

Share a specific example that showcases your analytical approach to identifying trends or issues in appeals, the solutions you implemented, and the measurable results. This demonstrates your problem-solving ability and understanding of revenue cycle management.

Highlight your proficiency in tools like Microsoft Excel or any healthcare-specific software for reporting. Provide examples of how you've used these tools to analyze data effectively and inform your decisions in managing denials and appeals.

Collaboration is key in the RCM role; discuss how you build relationships with other departments. Provide specific examples of successful collaborations and how they enhanced operational efficiency and revenue cycle outcomes.

Outline the methods you use to stay informed, such as subscribing to industry newsletters, participating in workshops, or joining professional organizations. Demonstrating your commitment to ongoing education reflects your passion for the field.

Discuss specific challenges encountered, such as regulatory changes or complex denial situations. Explain the steps you took to find solutions, showcasing your adaptability and critical thinking skills in navigating obstacles.

Describe your conflict-resolution skills, emphasizing how you'd approach the matter diplomatically while using facts to support your appeal. Highlight your ability to maintain professionalism even under pressure.

Discuss metrics that matter to you, such as improved appeal response time or lower denial rates. Reflect on the importance of achieving both team and organizational goals aligned with Tempus' mission.

Share your enthusiasm for Tempus’ mission and how your values align with the company. Highlight how your skills and experiences make you a perfect fit, expressing your passion for making a difference in healthcare.