Impactful Healthcare Payment Policy Analyst

point32health; Canton (MA); On-site; USD 64,000 - 96,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Retirement plans

Paid time off

Life and disability insurance with buy

Tuition program

Well-being benefits

Job summary

Point32Health seeks a Policy Analyst to investigate, research, and resolve first- and second-level appeals, and to maintain payment policies. The role involves applying CPT, HCPCS, ICD-10-CM coding knowledge to policy edits and collaborating with Policy, Medical Policy, and Utilization teams to drive decisions and savings opportunities.

This position supports work-from-home arrangements and requires 3–5 years of healthcare analysis experience, with strong communication and analytical skills to

Qualifications

• Bachelor's degree or equivalent in health care or related field required.
• Master's degree preferred for advanced roles.
• Experience: 3-5 years in related healthcare analysis or research.

Responsibilities

• Manage daily appeals and support first- and second-level decisions.
• Research proposed policies and assess financial impact.
• Develop and maintain payment policies.
• Apply CPT, HCPCS, ICD-10-CM coding knowledge to policy edits.
• Meet deadlines and collaborate with internal teams.

Skills

Policy analysis

Research skills

Communication skills

Healthcare policy knowledge

Education

Bachelor's degree or equivalent

Master's degree (preferred)

Tools

CPT/HCPCS coding knowledge

ICD-10-CM

Job description

Point32Health seeks a Policy Analyst to investigate, research, and resolve first- and second-level appeals, and to maintain payment policies. The role involves applying CPT, HCPCS, ICD-10-CM coding knowledge to policy edits and collaborating with Policy, Medical Policy, and Utilization teams to drive decisions and savings opportunities.

This position supports work-from-home arrangements and requires 3–5 years of healthcare analysis experience, with strong communication and analytical skills to