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:

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

  
  


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

  
  


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

  
  


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

  
  


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

  
  


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  Support continuous improvement through audit quality and productivity standards.

  
  


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  Maintain professional communication with providers and internal teams.

  
  


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

  
  

Required Qualifications:

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

  
  


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  2–3 years of inpatient coding experience

  
  


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

  
  


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  Proficient in MS-DRG and APR-DRG methodologies

  
  


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  Skilled in clinical validation and data analysis

  
  


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  Proficient in Microsoft Office and Windows OS

  
  


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  Excellent written communication and narrative review skills

  
  


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  Experience training or mentoring junior coders is a plus

  
  


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

  
  


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

  
  


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  Must not be a current or former CGI employee

  
  


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  Must not have an active or recent CGI application

  
  


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  No job hoppers (must show stable employment history)

  
  

Key Skills:

MSDRG Coding | DRG Validation | ICD-10-CM/PCS | Inpatient Coding | Clinical Validation | Data Analysis | Audit & Reporting | Communication | AHIMA Certified

Recruitment Process:

1. 
   

   Initial Interview – Recruitment Team (Virtual)

   
   


2. 
   

   Operations Interview

   
   


3. 
   

   Client Interview

   
   

To Apply:

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

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