Clinical Data Specialist

2 days ago

Pasay, National Capital Region, Philippines beBeeData Full time $21,600

Job Title:

  • A data-driven professional sought to support clinical and coding operations through accurate analysis of healthcare claims, focusing on Hierarchical Condition Categories (HCC) and Risk Adjustment Factor (RAF) scoring.
  • Key responsibilities include analyzing clinical data to identify opportunities for accurate HCC coding and RAF optimization, reviewing patient records and claims data to ensure risk-adjusted coding accuracy, and collaborating with coding and clinical teams to support audit processes and data integrity.
  • The ideal candidate will have a strong understanding of healthcare analytics, medical coding, and ICD-10 coding standards, as well as excellent analytical and problem-solving skills.
  • Additional requirements include a minimum of 2 years' experience in U.S. healthcare analytics or related fields, and a background in Nursing, Health Information Management, Public Health, or related fields.

Key qualifications include certification in medical coding, experience working with U.S. health plans, ACOs, or Medicare Advantage organizations, and strong knowledge of HCC coding, RAF scoring, and ICD-10 coding standards.

Why this role is important: This position plays a critical role in ensuring the accuracy and integrity of healthcare data, which has a direct impact on patient outcomes and healthcare system performance.

What you'll be doing: As a Healthcare Analyst, you will be responsible for analyzing complex healthcare data sets, identifying trends and anomalies, and developing insights to inform business decisions.

Requirements: Minimum 2 years' experience in U.S. healthcare analytics or related fields, strong understanding of healthcare analytics, medical coding, and ICD-10 coding standards, excellent analytical and problem-solving skills, and ability to work effectively in a team environment.

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