INPATIENT CODER

Western CBO; Las Vegas (NV); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive pay

Generous PTO

Excellent medical/dental/vision plans

401(k) with company match

SoFi student loan refinancing program

Career development opportunities

Job summary

Universal Health Services (UHS) WCBO seeks a dynamic Inpatient Coder for the Appeals department to analyze third party coding audits, draft detailed appeal letters, and review denial trends. The role involves DRG validation, interpreting payer rationale, and ensuring accurate reimbursements.

You will collaborate with nurse auditors and patient services while maintaining compliance with applicable laws and guidelines. Competitive benefits and professional growth opportunities are provided.

Qualifications

• DRG coding expertise and familiarity with audits.
• Ability to draft appeal letters and analyze payer rationale.
• Strong knowledge of medical record documentation.

Responsibilities

• Perform DRG validation reviews in response to audits from third party payers.
• Review audit findings letters from third party payers to understand audited codes and rationale.
• Analyze medical records to obtain supporting clinical documentation for billed diagnosis codes.
• Write detailed appeal letters based on clinical findings to third party payers to prevent downgrade payments.
• Make decisions to update DRGs or add/remove billed diagnosis codes based on clinical reviews.
• Assign DRG audits to nurse auditors when coding audit is based on clinical criteria.
• Provide analysis and assistance to the appeals department as needed.
• Assist customer service with patient complaints related to coding issues on medical bills.
• Provide a detailed charge/coding breakdown to assist with split billing scenarios.

Job description

Responsibilities

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO)

The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.

The Western Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. The primary responsibility of the DRG Coder is to analyze third party coding audits of paid claims, draft detailed appeal letters, evaluate clinical level of care and review denial trends.

Qualifications

Key Responsibilities include:

• Perform DRG (Diagnosis Related Group) validation reviews in response to audits from third party payers.
• Review audit findings letters from third party payers to obtain a clear understanding of audited diagnosis codes and underlying payer clinical / coding rationale.
• Analyze medical records to obtain supporting clinical documentation for billed diagnosis codes.
• Write detailed appeal letters based on clinical findings to third party payers to prevent downgrade payment recoveries.
• Make decision to update DRGs or remote or add to billed diagnose codes based on clinical reviews
• Assign DRG audits to nurse auditors when coding audit is based on clinical criteria.
• Provide analysis and assistance as needed to the appeals department.
• Assist customer service with patient complaints related to coding issues on their medical bills.
• Provide a detailed charge/coding breakdown to assist with medical claims that need to be split billed based on various clinical scenarios.
• Manage multiple spreadsheets including DRG inventory and inventory returned from vendors.
• Maintain educational guidebooks for multiple department workflows.
• Assist with drafting and maintaining appeal letter templates.
• Identify audit trends and provide feedback to management and to UHS acute care facilities.
• Adherence to all applicable laws, regulations and guidelines.
• Other duties as assigned.

Benefit & Rewards Highlights

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Pet Insurance
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

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