Medicare Policy Analyst

This is a fully remote position, open to applicants in New Jersey, +2 more states.

📋 Description

• Leverage your expertise in medical coding, billing, or clinical practices to create software and datasets utilizing information from national and state medical coverage policies.

• Conduct research and analysis of Medicare payment policies and regulatory updates to effectively organize and refresh content in our proprietary database.

• Prepare and deliver new files and updates to clients.

• Communicate with CMS or other payers to clarify ambiguities in policies or rectify publication errors.

• Address inquiries related to our data and collaborate with customers to resolve any issues.

• Lead quality assurance and analysis of the data we generate or acquire.

• Implement solutions that assist hospitals, clinics, and physicians in meeting regulations and ensuring appropriate payment for medical services.

• Work alongside skilled colleagues to develop solutions for complex challenges.

• Determine optimal ways to organize and present information to satisfy client or software requirements.

• Contribute innovative ideas that enhance and refine your team’s products and processes.

⛳️ Requirements

• A Bachelor’s Degree or higher AND four (4) years of experience in healthcare or medical coding within a private, public, governmental, or military setting OR a High School Diploma/GED along with eight (8) years of experience in the same fields.

• Registered Nurse (RN) certification.

• Experience in health information systems or medical billing.

• Possession of any of the following certifications: CCS-H, CCS-P, CPC, CPC-P, COC, CCA, RHIT, RHIA, or a strong working knowledge of ICD-10, CPT, and HCPCS coding practices.

• Experience in supporting, using, or implementing an HIS system, particularly in coding, compliance, billing, or insurance claim adjudication.

• Proficient understanding of medical terminology, procedures, and diagnoses.

• Familiarity with common disease processes, prevalent treatments, and diagnostic tests.

• Background in medical coding, billing, or auditing, particularly within hospital outpatient settings.

• Insight into medical insurance payment policies or processes.

• Excellent organizational skills with the ability to meet frequent short-term deadlines.

• Capability to work both independently and collaboratively with team members.

• Strong computer and data analysis skills (e.g., MS Office, Excel, database usage, or assisting in the design or troubleshooting of software solutions, particularly related to medical payments or compliance).

• Exceptional reading comprehension with the ability to interpret complex regulatory documents and extract essential concepts.

🏝️ Benefits

• Medical, Dental & Vision coverage.

• Health Savings Accounts.

• Flexible Spending Accounts for Health Care & Dependent Care.

• Disability Benefits.

• Life Insurance.

• Optional Benefits.

• Paid Time Off.

• Retirement Benefits.