Data Insights Specialist

3 days ago

Taguig, National Capital Region, Philippines beBeeHealthcare Full time $21,600
Job Title: Healthcare Data Specialist

Job Summary:


We are seeking a detail-oriented and analytical professional to join our team as a Healthcare Data Specialist. This role focuses on supporting clinical and coding operations through accurate data analysis, specifically involving Hierarchical Condition Categories (HCC) and risk adjustment methodologies.


Key Responsibilities:
  • Analyze clinical data to identify opportunities for accurate HCC coding and risk 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 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.
  • 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 is a plus.
  • Experience working with U.S. health plans, ACOs, or Medicare Advantage organizations.

This is an excellent 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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