Revenue Cycle Strategist for Post-Payment Appeals and Payer Relations

7 days ago


Chicago, Illinois, United States Tempus AI Inc. Full time
Job Description:

A highly skilled Revenue Cycle Strategist is needed to lead our dynamic team in managing post-payment appeals, developing refund policies, and handling payer audits. This critical role requires a strong background in revenue cycle management, complemented by paralegal expertise.

Key Responsibilities:
  • 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 track and improve the efficiency and effectiveness of the post-payment appeals process.
  • Create and maintain Standard Operating Procedures (SOPs) for the post-payment appeals team, ensuring compliance with all regulatory guidelines and payer requirements.
Payer Audit Management
  • Oversee the collection and organization of all necessary documentation in response to payer audits, ensuring meticulous documentation management.
  • Conduct thorough research to support audit responses and appeals.
  • Serve as the primary point of contact for all audit-related inquiries and correspondence, including writing clear, concise, and persuasive appeal response letters.
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.
  • Strong paralegal skills, including documentation management, legal research, and client communication, are highly desirable.
Estimated Salary Range: $120,000 - $150,000 per year

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