Healthcare Data Specialist

2 days ago

Angeles City, Central Luzon, Philippines beBeeHealthcare Full time $21,600
Healthcare Analyst

Role Overview:

We are seeking an analytical professional to join our team as a Healthcare Analyst. This role involves analyzing clinical data, identifying opportunities for accurate HCC coding and RAF optimization, and collaborating with coding and clinical teams to support audit processes and data integrity.


Key Responsibilities:
  • Review patient records, claims data, and provider documentation to ensure risk-adjusted coding accuracy
  • Analyze clinical data to identify trends or anomalies in healthcare data sets
  • Generate reports and dashboards that support care management, risk adjustment, and quality improvement initiatives
  • Collaborate with cross-functional teams to develop and implement data-driven strategies
  • Support compliance with CMS risk adjustment guidelines and payer-specific requirements
  • Maintain documentation and data validation procedures to ensure consistent analysis

Requirements:
  • 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
  • Experience working with healthcare data sets such as claims, EMR, encounter data
  • Proficient in using tools like Excel, Google Sheets, and data visualization platforms (e.g., Tableau, Power BI)
  • Familiarity with CMS guidelines and risk adjustment methodologies
  • Excellent analytical, organizational, and communication skills
  • Ability to work independently in a remote environment with minimal supervision

Preferred Qualifications:
  • Background in Nursing, Health Information Management, Public Health, or related fields
  • Certification in medical coding (e.g., CPC, CRC) is a plus
  • Experience working with U.S. health plans, ACOs, or Medicare Advantage organizations

As a member of our team, you will have the opportunity to make a measurable impact in improving patient care and data-driven clinical outcomes while enjoying the flexibility of remote work.

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