[Remote] MEDICARE POLICY ANALYST

Note: The job is a remote job and is open to candidates in USA. Solventum is a new healthcare company focused on improving lives through innovative solutions. The Medicare Policy Analyst will research and analyze Medicare payment policies, organize content in a proprietary database, and implement solutions to help healthcare providers comply with regulations and ensure proper payment for medical care.

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

Skills

• 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
• 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

Company Overview