Talent Job Seeker

CDI / DRG

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.).

Talent Job Seeker
Pasig
app.general.countries.Philippines

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Job ID: 9603993 / Ref: bff9543f03388a6d80c0da5c81187910