RCM Specialist: Medical Coding Operations
4 weeks ago
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
The Revenue Cycle Management team oversees reimbursement operations and strategies for Tempus' clinical laboratory testing. We are seeking an RCM Specialist to join our Internal Billing Operations team with a focus on supporting our Medical Billing Operations. This position will be responsible for supporting accurate, timely, and appropriate assignment or validation of ICD-10, CPT, and HCPCS coding and modifiers to achieve maximum reimbursement and reduce billing errors. The scope of this role may extend into other internal billing operational needs and workflows.
Key Responsibilities
Medical Coding Operations
* Abstract, assign, and/or audit ICD-10, CPT, and HCPCS coding for molecular oncology testing.
* Ensure that medical documentation is coded in a consistent, accurate, and timely manner.Identify and report error patterns, resolve issues associated with the coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors due to coding procedures.
* Adhere to all relevant regulations, including HIPAA, CMS guidelines, and payer requirements, and implement strategies to minimize claim denials.
Internal Billing Operations
* Efficiently manage worklists related to patient billing, medical records requests, coordination of benefits (COB), and expired insurance within the billing system.
* Troubleshoot and address any issues related to patient demographics, insurance information and/or claim submissions.
* Review clinical documents (e.g., progress notes, pathology reports) to select the most appropriate documentation to include with claim submissions.
* Update and ensure accuracy and consistency of all patient demographic information across internal systems.
* Analyze and document trends or patterns in daily workflows to enhance process efficiency and ensure clean claims submissions.
* Handle ad hoc requests and special projects as needed.
Requirements
* Bachelor's degree in business, healthcare administration, biology or genetics-related fields.
* HIM certification: RHIT, RHIA, CCS, CCS-A, CCS-H, CPC, or CPC-A
* 1+ years of oncology coding experience and/or Optum Encoder experience.
* Prior experience with healthcare reimbursement, insurance appeals, patient advocacy, laboratory billing, EDI enrollment, and/or payer portals is a plus.
* Experience in Microsoft Excel, Google Suite, and other data analysis tools.
Desired Attributes
* Strong organizational skills with the ability to be a self-starter who can work with minimal supervision.
* Proven ability to learn new skills quickly and adapt to new processes smoothly.
* Detail-oriented with a commitment to accuracy and thoroughness in all tasks.
* Creative mindset to problem solve, comfort with ambiguity, and confidence to ask key questions.
* Ability to work efficiently under time constraints.
* Willingness to be flexible and adapt quickly.
#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.
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