DRG Validation Specialist | 2.5+ Years DRGV/IP Audit Exp | Onsite

DRG Validation Specialist | 2.5+ Years DRGV/IP Audit Experience | Active CIC/CCS Required | Onsite | Quezon City, Taguig & Cebu

Work Locations: Quezon City / Taguig City / Cebu City

Work Setup: Onsite

Start Date: October 29, 2026

Openings: 7

Salary Package: ₱70,000–₱90,000

Certification: Active CIC, CCS, or CPC

Educational Attainment: College Graduate of BS Nursing or Medical Allied Course

Training Setup: Onsite

SOB: Requires Business Approval

At least 2 years and 6 months of DRGV / Inpatient Audit experience

Candidates with 3–5 years of Inpatient Coding experience may also be considered

Active CIC or CCS certification – REQUIRED

Candidates with CPC certification must have at least 2 years of DRG experience

College graduate of BS Nursing or Medical Allied Course

Strong knowledge of inpatient coding and DRG validation

If certification will expire within the next 6 months, the candidate must shoulder the certification renewal

Must be willing to work 100% onsite

The DRG Validation Specialist will review inpatient medical records to validate DRG (Diagnosis-Related Group) assignments and ensure that recommendations and findings are supported by appropriate clinical documentation and coding guidelines.

The role requires strong inpatient coding and DRG validation knowledge, attention to detail, and the ability to provide clear rationale and supporting evidence for review findings.

Review inpatient medical records for validation of DRG assignments

Analyze clinical documentation and coding information

Validate DRG assignments based on available documentation

Provide detailed rationale and supporting evidence for recommendations and findings

Identify discrepancies, unsupported diagnoses, and coding concerns

Utilize industry-recognized coding references to support review findings

Apply the ICD-10 Official Guidelines for Coding and Reporting

Utilize AHIMA Standards of Ethical Coding

Reference AHIMA Practice Briefs related to compliant querying

Utilize AHA Coding Clinics when applicable

Ensure findings are accurately documented and supported

Experience or knowledge of the following is an advantage:

3M Coding

Optum

Computer-Assisted Coding (CAC)

Abstracting Software

Meditech