job description
Join a dynamic healthcare team as a DRG Analyst and play a pivotal role in ensuring accurate medical coding and billing compliance. This position offers a ₱200,000 sign-on bonus for qualified certified medical coders, reflecting our commitment to attracting top-tier talent in the healthcare industry.
As a DRG Analyst, you will review, validate, and assign Diagnosis-Related Group (DRG) codes to ensure proper reimbursement and data integrity. Your expertise will directly impact financial accuracy, regulatory compliance, and operational efficiency for healthcare providers.
Based in the vibrant regions of Bali (Canggu, Ubud, Denpasar, Jimbaran, Nusa Dua, Kuta, or Badung), this role offers a unique opportunity to work in a tropical paradise while contributing to a critical function in the healthcare ecosystem. Whether you're a seasoned medical coder or a detail-oriented analyst, this position provides a rewarding career path with growth potential.
We are seeking professionals who thrive in a fast-paced environment, possess strong analytical skills, and are passionate about healthcare data accuracy. If you are a certified medical coder (e.g., CPC, CCS, or equivalent) with experience in DRG systems, we want to hear from you!
Responsibility
- Review and validate DRG coding assignments for accuracy, completeness, and compliance with regulatory standards (e.g., ICD-10, CMS guidelines).
- Analyze medical records, physician documentation, and clinical data to assign appropriate DRG codes.
- Collaborate with healthcare providers, billing teams, and auditors to resolve coding discrepancies and ensure proper reimbursement.
- Monitor and report on DRG coding trends, identifying areas for improvement in documentation or coding practices.
- Stay updated on changes in DRG methodologies, CMS policies, and healthcare regulations to maintain compliance.
- Conduct internal audits to verify coding accuracy and provide feedback to clinical and administrative staff.
- Assist in training and mentoring junior coders or staff on DRG coding best practices.
- Prepare detailed reports and presentations for management on coding performance, financial impact, and compliance metrics.
Qualifications
- Certification Required: Active certification as a medical coder (e.g., CPC, CCS, RHIA, or equivalent).
- Minimum 2+ years of experience in DRG coding, medical billing, or healthcare revenue cycle management.
- Proficiency in ICD-10-CM/PCS, CPT, and DRG grouping software (e.g., 3M Encoder, Optum).
- Strong understanding of healthcare reimbursement systems, including Medicare, Medicaid, and commercial payer policies.
- Exceptional attention to detail and ability to interpret complex medical documentation.
- Excellent analytical and problem-solving skills to identify and resolve coding discrepancies.
- Familiarity with EHR/EMR systems (e.g., Epic, Cerner) and Microsoft Office Suite (Excel, Word).
- Ability to work independently in a remote or hybrid setting while meeting deadlines.