
Senior Healthcare Data Analyst Position
6 days ago
Healthcare Data Specialist Role
">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.
">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
- 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
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