Medicare Policy Analyst

March 1

🗽 New York – Remote

Although this job is listed in New York, this company may be open to hiring remote in other states.

💵 $106.3k - $130k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Solventum

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Solventum is a healthcare company that develops innovative products and services aimed at improving patient outcomes and enhancing the efficiency of healthcare. The company offers a wide range of solutions including advanced wound care, oral care, health information and technology, and purification and filtration systems. Solventum is committed to evidence-based care and continuous healthcare education, providing support through peer-to-peer programs and innovative developments such as 3D printed aligner attachments. It places a strong emphasis on sustainability, aiming for 100% renewable electricity by 2030. With a focus on enabling better, smarter, safer healthcare, Solventum works closely with healthcare professionals to address chronic health needs and provide trusted, leading brands.

10,000+ employees

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🧬 Biotechnology

📋 Description

• Utilize your medical coding, billing, or clinical knowledge to develop software and data sets using information from national and state medical coverage policies. • Extensive research of medical policies and utilizes clinical understanding to represent policies with medical terminology and medical codes such as CPTs, HCPCs and ICDs. • Ability to manipulate data, think like a programmer, and draw upon a clinical background. • Work with a small passionate team on projects to improve medical billing, coding, and reimbursement across the nation. • Researching and analyzing Medicare payment policies and regulatory changes to organize and update content in our proprietary database. • Preparing and delivering new files and updates to customers. • Corresponding with CMS or other payers to clarify policy ambiguities or publication errors. • Responding to inquiries about our data or working with customers to resolve issues. • Leading QA and analyses of data we build or acquire. • Implementing solutions to help hospitals, clinics, and doctors comply with regulations and attain proper payment for medical care. • Collaborating with skilled colleagues to devise solutions to tricky challenges. • Determining how to best organize and represent information to meet client or software needs. • Contributing ideas that advance and improve team’s products & processes.

🎯 Requirements

• Bachelor’s Degree or higher AND (4) four years of healthcare or medical coding experience in a private, public, government or military environment • High School Diploma/GED from AND (8) eight years of healthcare or medical coding experience in a private, public, government or military environment • Registered Nurse (RN) • Experience in health information systems or medical billing • CCS-H, CCS-P, CPC, CPC-P, COC, CCA, RHIT, RHIA Certified, or a strong working knowledge of ICD-10, CPT & HCPCS coding practices • Experience supporting, using, or implementing an HIS system – especially for coding, compliance, billing, or insurance claim adjudication • Understanding of medical terminology, procedures & diagnoses • Knowledge of the common disease processes, common treatments, and diagnostic tests • Medical coding, billing, or auditing background – esp. hospital outpatient • Knowledge of medical insurance payment policies or processes • Strong organization skills; must be able to meet frequent short-term deadlines • Ability to work independently and collaboratively with team members • Strong computer & data analysis skills (e.g. MS Office, Excel, use of databases, or helping design or troubleshoot software solutions – especially related to medical payments or compliance) • Great reading comprehension with ability to interpret complex regulatory documents and extract key concepts

🏖️ Benefits

• Medical, Dental & Vision • Health Savings Accounts • Health Care & Dependent Care Flexible Spending Accounts • Disability Benefits • Life Insurance • Voluntary Benefits • Paid Absences • Retirement Benefits