Inpatient Coder - DRG Appeals Specialist

UHS; Las Vegas (NV); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Excellent medical, dental, vision

401(k) with company match

Career development opportunities

Pet insurance

Job summary

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO) is seeking an Inpatient Coder for the Appeals department. The role analyzes third party coding audits, drafts detailed appeal letters, and reviews clinical level of care to identify denial trends.

Responsibilities include DRG validation, reviewing audit letters, and providing analysis to support appeals. The position requires coding certification and DRG experience with strong MS Office skills.

Qualifications

• Minimum high school diploma or equivalent.
• Professional coding certification (CCA, CCS, CCS-P, CPC, RHIT, RHIA).
• IP DRG experience and 1–3 years coding experience (3–5 preferred).
• Strong Microsoft Office skills including Excel, Word, Outlook.

Responsibilities

• Perform DRG validation reviews in response to third party payers' audits.
• Review audit findings letters to understand audited diagnosis codes and rationale.
• Analyze medical records to obtain supporting clinical documentation for billed diagnoses.
• Write detailed appeal letters to third party payers based on clinical findings.
• Decide on updating DRGs or adding billed diagnosis codes based on reviews.
• Assign DRG audits to nurse auditors when criteria are clinical.

Skills

DRG coding

Audit analysis

Medical terminology

Documentation

Education

Professional coding certification

Tools

Excel

Word

Outlook

Job description

Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO) is seeking an Inpatient Coder for the Appeals department. The role analyzes third party coding audits, drafts detailed appeal letters, and reviews clinical level of care to identify denial trends.

Responsibilities include DRG validation, reviewing audit letters, and providing analysis to support appeals. The position requires coding certification and DRG experience with strong MS Office skills.