DRGV Specialist

Private Advertiser; Metro Manila; On-site; PHP 350,000 - 600,000; Full time

Job summary

Private Advertiser seeks a DRG coder/costing analyst to ensure accurate DRG coding, review medical records, and support cost analysis within a hospital setting. This role requires strong analytical skills, knowledge of DRG classifications, and collaboration with clinical and administrative teams to optimize revenue and compliance.

You will maintain up-to-date DRG guidelines, generate reports on case mix and revenue impact, and help train staff on coding standards while working in a fast-paced

Qualifications

• Certification in CIC, CCS, or CPC is required or preferred
• Minimum 2 years' experience with DRG systems, case costing, or healthcare coding
• Strong knowledge of DRG classification, ICD coding, and billing practices
• Proficient with healthcare information systems and data management software
• Excellent analytical and problem-solving skills with attention to detail
• Strong communication and teamwork across multidisciplinary teams

Responsibilities

• Analyze and review patient medical records for DRG coding accuracy
• Validate case costing data and identify discrepancies
• Maintain knowledge of DRG guidelines and regulatory requirements
• Collaborate with clinical and administrative teams to resolve coding issues
• Prepare reports on case mix, coding compliance, and revenue impact
• Support DRGV systems and databases maintenance
• Conduct training sessions on DRG coding standards
• Monitor coding quality and adherence to protocols
• Identify trends in case costing and suggest improvements
• Liaise with hospital vendors and regulatory bodies as needed

Skills

DRG systems

Case costing

Healthcare coding

ICD coding standards

Healthcare billing

Excel

Data analysis tools

Multidisciplinary communication

Education

CIC/CCS/CPC certification

Tools

Healthcare IT systems

Job description

Key responsibilities

• Analyze and review patient medical records to ensure accurate DRG coding and classification

• Validate case costing data and identify discrepancies or opportunities for optimization

• Maintain up-to-date knowledge of DRG guidelines, coding standards, and regulatory requirements

• Collaborate with clinical and administrative teams to resolve coding-related issues and queries

• Prepare comprehensive reports on case mix analysis, coding compliance, and revenue impact

• Support the implementation and maintenance of DRGV systems and databases

• Conduct training sessions for healthcare staff on DRG coding standards and best practices

• Monitor coding quality and ensure adherence to established protocols and policies

• Identify trends in case costing and provide recommendations for process improvements

• Liaise with external stakeholders including hospital information system vendors and regulatory bodies as required

What we're looking for

• Professional qualification or certification in CIC, CCS, CPC

• At least 2 years of experience working with DRG systems, case costing, or healthcare coding in a clinical or hospital setting

• Comprehensive knowledge of DRG classification systems, ICD coding standards, and healthcare billing practices

• Demonstrated proficiency with healthcare information systems and data management software

• Strong analytical and problem-solving skills with meticulous attention to detail

• Excellent communication abilities and capacity to work effectively with multidisciplinary teams

• Advanced proficiency in Microsoft Excel and data analysis tools

• Ability to manage multiple priorities and meet strict deadlines in a fast-paced environment

• Certification in DRG coding or equivalent professional qualification is preferred

• Experience with healthcare auditing and quality assurance processes is advantageous