cdi / drg

1 day ago

Pasig, National Capital Region, Philippines TASQ Staffing Solutions Full time ₱900,000 - ₱1,200,000 per year

Work Setup/Shift: WFO / Night shift

Start Date: ASAP

Qualifications:

  • Bachelors Degree in Nursing (BSN) or equivalent healthcare-related degree.
  • Must have a Medical Coding License
  • 6 months to 1 year in a US Healthcare account
  • Knowledge of anatomy and pathophysiology, disease process and management
  • Coding knowledge (ICD-10-CM & PCS, Clinical codes and compliance, DRGs with MCCs, CCs, SOI, ROM, APR-DRG and MSDRG required)
  • Experience with English grammar/written skills and proper query creation
  • Must be amenable to report 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 up-to-date.Identify 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.).

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