USRN Nurses (Clinical Documentation, Coding)

Job Title: CDI / DRG Specialist (Pasig) | 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

• 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.
• 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.).