Medicare Policy Analyst

Solventum

. Utilize your medical coding, billing, or clinical knowledge to develop software and data sets using information from national and state medical coverage policies.

Posted 5/10/2026full-timeRemote • New Jersey, New York, Pennsylvania • 🇺🇸 United StatesMid-LevelSenior💰 $96,000 - $132,000 per yearWebsite

About the role

Key responsibilities & impact

Utilize your medical coding, billing, or clinical knowledge to develop software and data sets using information from national and state medical coverage policies.
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

Requirements

What you’ll need

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
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.

Benefits

Comp & perks

Medical, Dental & Vision
Health Savings Accounts
Health Care & Dependent Care Flexible Spending Accounts
Disability Benefits
Life Insurance
Voluntary Benefits
Paid Absences
Retirement Benefits

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical codingbillingclinical knowledgeICD-10CPTHCPCSdata analysishealth information systemsmedical terminologyauditing

Soft Skills

strong organization skillsability to work independentlycollaborativegreat reading comprehensionproblem-solvingcommunicationleadershipattention to detailtime managementadaptability

Certifications

Registered Nurse (RN)CCS-HCCS-PCPCCPC-PCOCCCARHITRHIABachelor’s Degree