On Belay Health Solutions

Risk

• Review and validate AI-identified risk adjustment coding opportunities within medical records
• Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions
• Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities
• Develop feedback loop with On Belay’s Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to: Identification of quality improvement opportunities in individual physician coding
• Any other related duties assigned at manager’s discretion

Medicare Risk Adjustment Specialist I

Business Analyst

• Perform in-depth data analysis to identify trends, patterns, and opportunities within healthcare datasets
• Write complex SQL queries to extract, manipulate, and analyze large datasets
• Develop analytical reporting solutions and dashboards that support operational and financial decision-making
• Communicate trends, variances, and performance results to technical and non-technical stakeholders
• Partner with business teams to understand needs and deliver data-driven recommendations
• Create and maintain process documentation for data workflows, reporting logic, and methodologies
• Perform monthly refresh validations, variance identification, and root cause analysis across reporting and analytic outputs
• Investigate data anomalies, reconcile discrepancies, and independently troubleshoot reporting issues
• Support the standardization and ongoing improvement of reporting logic and methodologies
• Work independently to prioritize and manage multiple analytic requests in a fast-paced environment
• Perform other duties as assigned

Medicare Risk Adjustment Specialist I

Healthcare Business Analyst