MEDICARE POLICY ANALYST

3M; New York (NY); On-site; USD 106,000 - 130,000; Full time

Job summary

An innovative company is seeking a Medicare Policy Analyst to enhance healthcare through data-driven solutions. This role involves analyzing Medicare policies, collaborating with a passionate team, and utilizing medical coding expertise to improve billing processes. You will have the chance to make a significant impact by ensuring compliance and optimizing payment systems for healthcare providers. Join a forward-thinking organization that values curiosity and teamwork, and be part of a mission to transform healthcare for the better. If you are driven by a desire to innovate and improve lives, this opportunity is for you.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Health Savings Accounts

Flexible Spending Accounts

Disability Benefits

Life Insurance

Paid Absences

Retirement Benefits

Qualifications

• Bachelor’s Degree or 4 years of healthcare coding experience required.
• Strong coding knowledge (ICD-10, CPT, HCPCS) is essential.

Responsibilities

• Research and analyze Medicare payment policies to update the database.
• Collaborate with a team to implement solutions for medical billing.

Skills

Medical Coding

Data Analysis

Healthcare Knowledge

Regulatory Understanding

Communication Skills

Education

Bachelor's Degree

High School Diploma/GED

Tools

MS Office

Excel

Health Information Systems

Job description

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: Privacy Policy continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Description:

Medicare Policy Analyst (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 that change patients' lives for the better while enabling healthcare professionals to perform at their best.

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 policies and utilizes clinical understanding to represent policies 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.
• 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 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: Total Rewards.

Responsibilities 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.

Solventum Global Terms of Use and Privacy Statement

Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms.

Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.

Our Story

At Solventum, we create breakthrough solutions for our customers’ toughest challenges by pioneering game-changing innovations that change patients’ lives for the better — while enabling healthcare professionals to perform at their best.