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13 hours ago
This position plays a pivotal role in supporting clinical and coding operations through precise data analysis.
We are seeking an experienced Healthcare Data Analyst to join our team. The successful candidate will have a strong background in U.S. healthcare analytics, medical coding, or risk adjustment, with a minimum of 2 years' experience in the field.
- 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
- 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
In addition to the required qualifications, we also welcome candidates with backgrounds in Nursing, Health Information Management, Public Health, or related fields. Certification in medical coding is a plus.
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