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 data from national and state medical coverage policies.

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

• Prepare and deliver new files and updates to clients.

• Communicate with CMS or other payers to clarify any ambiguities in policy or correct publication errors.

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

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

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

• Partner with talented colleagues to create innovative solutions for complex challenges.

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

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

⛳️ Requirements

• Bachelor’s Degree or higher along with four (4) years of experience in healthcare or medical coding within a private, public, government, or military setting, OR a High School Diploma/GED accompanied by eight (8) years of healthcare or medical coding experience in similar environments.

• Registered Nurse (RN) certification.

• Proficiency 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 Certified, or extensive knowledge of ICD-10, CPT, and HCPCS coding practices.

• Experience in supporting, using, or implementing a health information system, particularly for coding, compliance, billing, or insurance claim adjudication.

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

• Knowledge of common disease processes, treatments, and diagnostic tests.

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

• Familiarity with medical insurance payment policies or processes.

• Excellent organizational skills; 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 management, 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.

• Voluntary Benefits.

• Paid Absences.

• Retirement Benefits.