Healthcare Operations Specialist

1 day ago

Paranaque City, Calabarzon, Philippines beBeeData Full time $21,600
Healthcare Data Analyst

We are seeking a detail-oriented and analytical professional to support clinical and coding operations through accurate data analysis. This role focuses on analyzing 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

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
  • Familiarity with CMS guidelines and risk adjustment methodologies
  • Excellent analytical, organizational, and communication skills

Benefits:
  • Remote work opportunity with minimal supervision
  • Opportunity to make a measurable impact in improving patient care and data-driven clinical outcomes

About the Role:

This is an exciting opportunity for a skilled analyst to join our team and contribute to improved patient outcomes and operational performance.

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