MSDRG Nurse / DRG Validation Auditor

Gratitude Inc

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1 month ago

MSDRG Nurse / DRG Validation Auditor

2-5 Year(s)

60 - 70 Thousand p.m

Manila (Taguig)

Job Description

Key Skills

Case Management medical record system INPAITENT CODING ICD-10 Clinical Authorization

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HIRING: MSDRG Nurse / DRG Validation Auditor

Work Location: Taguig City – Hybrid Setup

Work Schedule: Night Shift

Salary Range: ₱60,000 – ₱70,000

Headcount: 1

Position Overview:

The DRG Validation Auditor is part of the DRG Validation Team and is responsible for reviewing inpatient medical records to ensure accurate coding, proper DRG assignment, and correct reimbursement for clinical services.

This role helps identify potential overpayments or underpayments for various healthcare providers, including hospitals, rehab centers, and skilled nursing facilities.

Key Responsibilities:

Review inpatient medical records to validate ICD-10 diagnosis/procedure codes, discharge status, and DRG assignment.

Ensure accuracy in Hospital-Acquired Conditions (HACs) and Present on Admission (POA) indicators.

Prepare detailed rationales and results letters for each review with proper references.

Apply appropriate coding guidelines and standards in line with client requirements.

Provide feedback and collaborate with Clinical Nurse Auditors or Physician Advisors as needed.

Support continuous improvement through audit quality and productivity standards.

Maintain professional communication with providers and internal teams.

Comply with company policies and reporting requirements (timesheets, travel, productivity reports).

Required Qualifications:

Active AHIMA credentials (RHIT, RHIA, or CCS) – CCS preferred

2–3 years of inpatient coding experience

Strong knowledge of ICD-10-CM/PCS coding and DRG reimbursement

Proficient in MS-DRG and APR-DRG methodologies

Skilled in clinical validation and data analysis

Proficient in Microsoft Office and Windows OS

Excellent written communication and narrative review skills

Experience training or mentoring junior coders is a plus

Detail-oriented, analytical, and able to meet strict deadlines

Must be amenable to hybrid setup in Taguig (Night Shift)

Must not be a current or former CGI employee

Must not have an active or recent CGI application

No job hoppers (must show stable employment history)

Key Skills:

Recruitment Process:

Initial Interview – Recruitment Team (Virtual)

Operations Interview

Client Interview

To Apply:

Send your CV to valentina.gratitude.recruit@gmail.com

Use subject line: “MSDRG Nurse / DRG Validation Auditor – Taguig

Role

Nurse

Timings

Night Shift (Permanent)

Industry

Medical / Healthcare / Hospital

Work Mode

Hybrid

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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