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MEDICARE POLICY ANALYST

Remote · South Korea Full-time

Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers’ toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ applies to any personal information you submit. 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) 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

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