Client Partner – Inpatient DRG Nursing Auditor
Join our team in Manila as Inpatient DRG Nursing Auditor. If you’re a registered nurse with experience in medical coding and a passion for ensuring accurate billing and coding practices, we want to hear from you! Apply now and take the next step in your career today.
Work location: Mckinley Hill, Taguig City
Key responsibilities
Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
Record audit results and document finding notes based on policies using professional clinical resources
Perform provider appeals reviews and render decision to either uphold or overturn original finding
Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
Propose new audit concepts supported by your research and analysis
Define new audit concept criteria and test and validate new concepts developed by analytics team
Escalate facility issues per client guidance
Job Requirements
Good Comprehension skills
Strong attention to detail and communication skills
Curious and willing to ask relevant questions
Ability to understand client guidelines related to insurance advantage claims
Qualifications
Must be Philippine Registered Nurse with Active license
Must have an experience in clinical and audit in IP DRG