USRN Nurses
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Salary Not Disclosed
1 Vacancy
Job Description
Job Title: CDI / DRG Specialist (Manila) Onsite
Work Arrangement/Shift: Onsite (Work From Office) Night Shift
Start Date: ASAP (this June 2025)
Qualifications:
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Bachelors degree in Nursing or a related healthcare field.
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Must hold a valid Medical Coding License.
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6 months to 1 year of experience working in a U.S. healthcare account.
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Solid understanding of anatomy pathophysiology disease processes and treatment management.
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Proficient in medical coding standards including ICD-10-CM & PCS DRG classifications (MSDRG APR-DRG) and related clinical coding compliance.
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Skilled in written English and effective in creating clinical queries.
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Willing to work onsite in Ortigas Pasig City.
Responsibilities:
1. Clinical Documentation Review & Improvement:
- Review patient medical records including progress notes laboratory results and physician documentation.
- Work closely with healthcare providers to ensure that clinical documentation is accurate complete and gaps in documentation and query physicians to clarify diagnoses and procedures for accurate coding.
- Ensure that the documentation supports the correct DRG (Diagnosis-Related Group) assignment and that it aligns with U.S. coding standards and guidelines.
2. DRG Assignment & Compliance:
- Assign DRGs based on the clinical documentation provided and verify that DRG codes are correct for reimbursement purposes.
- Monitor DRG trends and ensure that any discrepancies or issues are flagged and resolved in a timely manner.
- Collaborate with coding teams to ensure that medical coding aligns with clinical documentation and DRG assignments.
- Maintain a thorough understanding of DRG-based reimbursement systems and U.S. healthcare regulations (CMS ICD-10-CM/PCS etc.).
Employment Type
Full Time
