Inpatient Coder

Responsibilities

Atlantic Region CBO:

The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals.

The Atlantic 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.

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:

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation's largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. .

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Qualifications

Position Requirements:

• High school diploma or equivalent
• Professional coding certification (CCA, CCS, CCS-P, CPC, RHIT, RHIA (One required))
• IP DRG experience
• 1-3 years coding experience, 3-5 years (preferred)
• Strong Microsoft Office skills (Excel, Word, Outlook)
• An understanding of anatomy, physiology, pharmacology, microbiology and medical terminology is required.
• Familiarity with appeals and 1-3 years of healthcare business office experience preferred

EEO Statement:

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams:

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.