Healthcare Analyst
- Philippines
- US$1,800 per month
- Permanent
- Full-time
Compensation: $1,800 USD/monthPosition Summary:We are seeking a detail-oriented and analytical Healthcare Analyst to join our team remotely. This role 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 has a solid background in U.S. healthcare data, understands medical coding and risk adjustment models, and can deliver insights that support improved patient outcomes and operational performance.Key Responsibilities:Analyze clinical data to identify opportunities for accurate HCC coding and RAF optimizationReview patient records, claims data, and provider documentation to ensure risk-adjusted coding accuracyCollaborate with coding and clinical teams to support audit processes and data integrityGenerate reports and dashboards that support care management, risk adjustment, and quality improvement initiativesTrack performance metrics and highlight trends or anomalies in healthcare data setsSupport compliance with CMS risk adjustment guidelines and payer-specific requirementsMaintain documentation and data validation procedures to ensure consistent analysisRequirements:Minimum of 2 years' experience in U.S. healthcare analytics, medical coding, or risk adjustmentStrong knowledge of HCC coding, RAF scoring, and ICD-10 coding standardsExperience working with healthcare data sets such as claims, EMR, encounter dataProficient in using tools like Excel, Google Sheets, and data visualization platforms (e.g., Tableau, Power BI)Familiarity with CMS guidelines and risk adjustment methodologiesExcellent analytical, organizational, and communication skillsAbility to work independently in a remote environment with minimal supervisionPreferred Qualifications:Background in Nursing, Health Information Management, Public Health, or related fieldsCertification in medical coding (e.g., CPC, CRC) is a plusExperience working with U.S. health plans, ACOs, or Medicare Advantage organizationsJoin our team and make a measurable impact in improving patient care and data-driven clinical outcomes—while enjoying the flexibility of remote work.