DRG Appeals Specialist — Inpatient Coding & Denials Expert

Health Business Solutions LLC; Philippines; On-site; PHP 279,000 - 390,600; Full time

Job summary

A healthcare solutions company is seeking a skilled individual to handle inpatient coding and DRG appeals in the Philippines. You will review medical records, analyze payer denials, and prepare compliant appeal letters while maintaining compliance with HIPAA regulations. The ideal candidate has strong expertise in ICD-10 coding, exceptional written communication skills, and the ability to work independently. Join us to support quality initiatives and improve coding accuracy within the healthcare sector.

Qualifications

• Inpatient Coding Experience is required.
• Strong working knowledge of ICD-10-CM and ICD-10-PCS is expected.
• Experience with DRG appeals or inpatient coding denials is essential.

Responsibilities

• Review inpatient medical records and validate diagnoses and procedures.
• Analyze payer denials, including DRG downgrades and clinical validation.
• Prepare compliant DRG appeal letters using official guidelines.
• Defend secondary diagnoses based on documentation and standards.
• Collaborate with teams to resolve complex cases.
• Maintain compliance with HIPAA and privacy regulations.

Skills

Inpatient Coding Experience

ICD-10-CM and ICD-10-PCS knowledge

Analysis of DRG appeals

Attention to detail

Excellent written communication

Job description

A healthcare solutions company is seeking a skilled individual to handle inpatient coding and DRG appeals in the Philippines. You will review medical records, analyze payer denials, and prepare compliant appeal letters while maintaining compliance with HIPAA regulations. The ideal candidate has strong expertise in ICD-10 coding, exceptional written communication skills, and the ability to work independently. Join us to support quality initiatives and improve coding accuracy within the healthcare sector.