Medicare Policy Analyst
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Job Description
Medicare Policy Analyst leveraging medical coding and billing expertise to impact healthcare solutions at Solventum. Focused on enhancing Medicare payment policies and collaborating with healthcare professionals.
Responsibilities:
- 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
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