MEDICARE POLICY ANALYST

SOLVENTUM•New York, NY

2d•Remote

About The Position

Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers’ toughest challenges. This position will utilize medical coding, billing, or clinical knowledge to develop software and data sets using information from national and state medical coverage policies. This involves extensive research of medical policies and utilizes clinical understanding to represent policies with medical terminology and medical codes such as CPTs, HCPCs and ICDs. Key skills to succeed include the ability to manipulate data, think like a programmer, and draw upon a clinical background, medical coding, or reimbursement knowledge. You will be working with a small passionate team and be involved in projects that improve medical billing, coding, and reimbursement across the nation. As a Medicare Policy Analyst, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world.

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
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Nice To Haves

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

Responsibilities

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
Complying with corporate policies, procedures and security standards while performing assigned duties.