Medicare Policy Analyst

🕒 May 10

🏖️ New Jersey, New York, +1 more states – Remote

🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $96k - $132k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Solventum

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

📚 Education

🧘 Wellness

Healthcare Insurance • Education • Wellness

Solventum is a healthcare-focused company renowned for its innovative solutions aimed at improving medical and oral care outcomes. The company offers a variety of medical technologies, including advanced wound care, surgical solutions, and sterilization products. Solventum also provides advanced oral care solutions, health information and technology services, and purification and filtration products for biopharmaceutical applications. Furthermore, Solventum places a strong emphasis on sustainability and education, providing resources and training for healthcare professionals globally. Their commitment to innovation and better healthcare has made them a leader in the healthcare industry, dedicated to enhancing patient safety and healthcare efficiencies.

📋 Description

• Utilize your medical coding, billing, or clinical knowledge to develop software and data sets using information from national and state medical coverage policies. • Researching and analyzing Medicare payment policies and regulatory changes in order 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 that 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 your 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 OR 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 • Any of the following: 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