R01122310 R&D Clinical and Medical Coding Analyst - Remote

Weingart Foundation; Deutschland; Remote; EUR 60.000 - 80.000; Vollzeit

Zusammenfassung

A leading healthcare solutions company seeks an R&D Clinical & Medical Coding Analyst to provide expertise in coding methodologies while working remotely. Candidates should possess a Bachelor's Degree and at least 5 years of experience in outpatient medical coding, demonstrating strong analytical and collaborative skills. This role offers competitive pay and opportunities for professional growth.

Leistungen

Competitive salary

Health and wellbeing programs

Qualifikationen

• 5 years’ experience in the healthcare industry.
• Experience with outpatient medical coding and billing.
• Ability to collaborate with clinicians and researchers.

Aufgaben

• Provide expertise in clinical content development.
• Contribute to research efforts on healthcare methodologies.
• Maintain documentation for methodologies updates.

Kenntnisse

Medical coding and billing operations

Healthcare claims processing optimization

Cross-functional teamwork

Database management

Ausbildung

Bachelor’s Degree

Tools

Excel

Jobbeschreibung

R&D Clinical & Medical Coding Analyst - Remote

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 Will Make in this Role

Solventum HIS is an international leader in designing and maintaining healthcare payment and quality outcome systems and advancing value-based care. We work closely with Medicare, Medicaid and commercial insurers on hospital, outpatient and population payment models and design quality outcome programs that promote patient safety and reduce avoidable costs. We also support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality. Here, you will make an impact by:

Providing subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of the Solventum outpatient public and proprietary groupers, code editors, and software including Tricare, Home Health, IOCE (Integrated Outpatient Code Editor), and EAPG (Enhanced Ambulatory Payment Grouper). These methodologies utilize healthcare data including diagnostic and procedural codes for determining payment and quality in healthcare.
Contributing and coordinating with the research efforts related to the methodologies, provide input into the prioritization of the potential research enhancements.
Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications.
Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification.
Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.

Your Skills and Expertise
To set you up for success in this role from day one, Solventum is looking for candidates who must have the following qualifications:

Bachelor’s Degree AND 5 years’ experience in the healthcare industry in one or more of the following: outpatient medical coding and billing operations, outpatient prior authorization or denials management, outpatient healthcare claims and processing optimization, payor claims design and edit management, and outpatient healthcare services research and analytics.
AND

In addition to the above requirements, the following are also required:

Significant experience working with excel, databases, and ability to learn computer applications for analysis.
Comfortable in a multicultural, complex, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well.
Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.
Must demonstrate the ability to collaborate effectively with cross-functional teams—including clinicians, researchers, and engineers—to communicate and train on clinical workflows, healthcare coding systems, and patient classification methodologies, while providing enthusiastic leadership that drives team engagement and performance.

Additional qualifications that could help you succeed even further in this role include:

Master's degree in health field, clinical informatics, clinical coding, and/or HIM credentials.
Familiarity with patient classification research and development:Outpatient coding and payment systems
Commercial, Medicare and Medicaid environments
Risk adjustment
Deep Knowledge of ICD-10-CM, CPT, NDC, and APC, with additional knowledge of ICD-10-PCS, HCPCS, APC, HCC, and DRG.
Ability to evaluate research questions, analyze results and statistical output and patterns, and document hypotheses and recommendations.
Healthcare software product development experience, bringing products from initial concept to release.
Healthcare payer, delivery or industry experience in healthcare quality, population health, care management

Work location: Remote

Travel – May include up to 5%

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.