Clinical Data Analyst

1 week ago

Hagonoy, Central Luzon, Philippines beBeeHealthcare Full time $21,600
Healthcare Analyst Job Description

We are seeking a detail-oriented and analytical professional to fill the role of Healthcare Analyst. This position 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.


The ideal candidate will have experience in U.S. healthcare analytics, medical coding, or risk adjustment, with strong knowledge of HCC coding, RAF scoring, and ICD-10 coding standards. They will be proficient in using tools like Excel, Google Sheets, and data visualization platforms such as Tableau or Power BI.

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.
  • 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 such as Tableau or 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.

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