Certified Payment Policy Analyst

Job Summary

Researching and developing payment policies, the full-time Certified Payment Policy Analyst will coordinate the distribution and maintenance of payment policies while working remotely within the greater Baltimore metropolitan area, with occasional in-office meetings.

Key responsibilities

• Conduct in-depth research on payment policy topics, evaluating CMS guidance and industry standards
• Write evidence-based payment policies and operating procedures related to reimbursement methodologies and coding rules
• Maintain the Payment Policy Reference Manual and ensure accurate dissemination of policies to relevant teams

Required qualifications

• Bachelor's Degree in Health Administration, Business, Finance, Nursing, or related discipline, or equivalent work experience
• Certified Coder (CCS or CPC) certification from AHIMA or AAPC
• Minimum of 3 years of experience in payment policy, reimbursement policy, or claims configuration in a healthcare setting
• Advanced knowledge of CPT, HCPCS, ICD-10-CM/PCS coding systems
• Experience in technical writing and reimbursement methodologies