Medicare Policy Analyst
Remote - New York, United States
Job Description:
Medicare Policy Analyst (Solventum)
3M Health Care is now Solventum
At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.
We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.
The Impact You’ll Make in this Role
In this position you will utilize your 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 polices and utilizes clinical understanding to represent polices 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. Here, you will make an impact by:
- 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
Your Skills and Expertise
To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications:
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
Additional qualifications that could help you succeed even further in this role include:
- 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
Work location: Remote-United States
Travel: May include up to 10%[domestic/international]
Relocation Assistance: Not authorized
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).
Supporting Your Well-being
Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.
Applicable to US Applicants Only:The expected compensation range for this position is $106,331 - $129,960, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-RewardsResponsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.
Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.
Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.
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Job Profile
Must be legally authorized to work Must be legally authorized to work in country Must be legally authorized to work in country of employment Must be legally authorized to work in country of employment without sponsorship Must be legally authorized to work in country of employment without sponsorship for employment visa status Remote
Benefits/PerksCompetitive pay Competitive pay and benefits Dental Disability benefits Flexible Spending Accounts Health Savings Accounts Life Insurance Medical Paid absences Relocation assistance Remote-first company Retirement benefits Vision
Tasks- Collaborate on projects
- Data Analysis
- Implement solutions
- Lead QA
- Prepare updates
- Research medicare policies
- Resolve issues
- Respond to inquiries
- Training
Analysis Auditing Billing Branding Clinical knowledge Coding Communications Compliance Corporate policies CPT Data Data analysis Database Data manipulation Data Science Excel HCPCS Healthcare Health information systems ICD ICD-10 Identity Information systems IT Medical Coding MS Office Organization Programming Research Security Technology Training
Experience4 years
EducationBachelor's degree GED Higher High School High school diploma High school diploma/GED
CertificationsCCS Registered Nurse RHIA RHIT RN
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9