USRN Nurses (Clinical Documentation, Coding) - Pasig

Job Title: CDI / DRG Specialist (Pasig) | Onsite
Work Arrangement/Shift: Onsite (Work From Office), Night Shift
Start Date: ASAP (this June 2025)

Qualifications:

Bachelors degree in Nursing or a related healthcare field.

Must hold a valid Medical Coding License.

6 months to 1 year of experience working in a U.S. healthcare account.

Solid understanding of anatomy, pathophysiology, disease processes, and treatment management.

Proficient in medical coding standards, including ICD-10-CM & PCS, DRG classifications (MSDRG, APR-DRG), and related clinical coding compliance.

Skilled in written English and effective in creating clinical queries.

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 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.).