Senior Clinical Data Analyst

23 hours ago


Cainta, Calabarzon, Philippines beBeeHealthcare Full time $21,600
About the Role

We are seeking a detail-oriented and analytical professional to join our team as a Healthcare Analyst. This role focuses on supporting clinical and coding operations through accurate data analysis, specifically involving Hierarchical Condition Categories (HCC), Risk Adjustment Factor (RAF) scoring, and healthcare claims review.

Key Responsibilities:
  • Analyze clinical data to identify opportunities for accurate HCC coding and RAF optimization
  • Review patient records, claims data, and provider documentation to ensure risk-adjusted coding accuracy
  • Collaborate with coding and clinical teams to support audit processes and data integrity
  • Generate reports and dashboards that support care management, risk adjustment, and quality improvement initiatives
  • Track performance metrics and highlight trends or anomalies in healthcare data sets
  • Support compliance with CMS risk adjustment guidelines and payer-specific requirements
  • Maintain documentation and data validation procedures to ensure consistent analysis
About You

To succeed in this role, you will need a minimum of 2 years' experience in U.S. healthcare analytics, medical coding, or risk adjustment. Strong knowledge of HCC coding, RAF scoring, and ICD-10 coding standards is also essential. Additionally, you should be proficient in using tools like Excel, Google Sheets, and data visualization platforms, and have familiarity with CMS guidelines and risk adjustment methodologies. Excellent analytical, organizational, and communication skills are also required. Finally, you should be able to work independently in a remote environment with minimal supervision.


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