Remote Clinical Analyst: Healthcare Payments & Analytics

Solventum; East Hartford (CT); On-site; USD 108,000 - 148,000; Full time

Job summary

Solventum is seeking a remote HIS Clinical Analyst to design and maintain outpatient clinical methodologies, aligning coding systems (ICD-10-CM, CPT, HCPCS) with payment and quality outcomes. You will validate data, support research initiatives, and collaborate with product and development teams to implement enhancements across multiple healthcare settings.

The role requires 5+ years in healthcare analytics, strong coding proficiency, and experience with Excel and databases.

Qualifications

• Bachelor's degree or higher from an accredited institution with 5+ years in healthcare (outpatient coding/billing, denials management, claims design, analytics).
• Strong expertise in HCPCS/CPT, ICD-10-CM, and standard claims processing; familiarity with ICD-10-PCS, APC and DRG concepts.

Responsibilities

• Design, develop and maintain outpatient public and proprietary methodologies, code editors and software including Tricare, Home Health, IOCE and EAPG.
• Perform validation and testing of healthcare data to evaluate methodology behavior and identify anomalies.
• Collaborate with Research and Product teams to translate clinical concepts into documented specifications.
• Work with Chief Product Owner and Development to drive enhancements using ICD-10-CM/CPT/HCPCS coding systems.
• Maintain process documentation and produce update summaries using C&ER standards.

Skills

HCPCS/CPT

ICD-10-CM

ICD-10-PCS

APC/DRG

Excel

Databases

AI in analytics

Education

Bachelor's degree or higher

Tools

Tricare

Home Health

IOCE

EAPG

Job description

Solventum is seeking a remote HIS Clinical Analyst to design and maintain outpatient clinical methodologies, aligning coding systems (ICD-10-CM, CPT, HCPCS) with payment and quality outcomes. You will validate data, support research initiatives, and collaborate with product and development teams to implement enhancements across multiple healthcare settings.

The role requires 5+ years in healthcare analytics, strong coding proficiency, and experience with Excel and databases.