Job Description

Salary: $116,000 - 156,000 per year Requirements:

• We require RHIA, RHIT, and/or CCS credentials with strong knowledge of ICD-9-CM and ICD-10-CM/PCS diagnosis and procedure coding, as well as MS-DRG assignment.
• We require a minimum of 5 years of coding experience in an acute care, teaching hospital, or inpatient environment.
• We require at least 5 years of proven inpatient and/or outpatient coding experience in an acute care or teaching setting.
• We require knowledge of anatomy and physiology, pathophysiology, and medical terminology.
• We strongly prefer working knowledge of ICD-10-CM/PCS and the ability to interpret complex disease processes.
• We need extensive familiarity with reimbursement models and federal, state, and payer-specific rules related to documentation, coding, and medical necessity.
• We prefer prior experience using an electronic medical record system, especially EPIC, and the 3M encoder.
• We expect accurate use of coding guidelines, including ICD-10-CM/PCS, UHDDS, and CMS standards.
• We look for strong analytical, documentation, and communication skills.
• We require the ability to work independently and maintain a high level of coding accuracy.
• We need candidates who can meet physical demands including sitting, standing, light lifting, and repeated hand and finger motion.
• We require corrected vision and hearing sufficient for computer-based work and normal conversation.

• We review patient medical records retrospectively to validate diagnosis and procedure code assignment and confirm MS-DRG accuracy.
• We analyze claims and coding data to support appeal decisions and challenge proposed DRG or coding changes from payers and auditors.
• We provide feedback and identify documentation and coding trends for Network Coding and CDMP Managers to support education across the care team.
• We partner with physician liaisons to review records selected by RAC, MIC, CGI, QIO, and other external auditors.
• We may assist with additional medical necessity reviews when needed.
• We develop persuasive appeal arguments to defend coding decisions and respond to outside payer determinations.
• We draft appeal letters and supporting coding rationale for network coding cases.
• We identify clinical documentation improvement opportunities and work with physicians, nurses, coders, and other team members to resolve them.
• We may participate in Administrative Law Judge hearings as needed.
• We spend about 20% of our time coding and abstracting patient records using ICD-10-CM/PCS, UHDDS, and CMS guidelines.
• We use the 3M Encoder to verify and assign diagnosis and procedure codes and determine MS-DRG groupings.
• We enter coded medical record information into EPIC and maintain a 95% coding accuracy rate based on quality review.
• We query physicians when documentation is unclear, inconsistent, incomplete, or insufficient for coding assignment.

• CMS
• CGI
• Support
• Network
• ARM
• C++

More:

We are St. Lukes University Health Network, an organization committed to excellence in caring for the sick and injured, educating physicians, nurses, and other health care providers, and expanding access to care across the communities we serve regardless of ability to pay. Our employees are our greatest strength, and we value the skills, experience, and compassion they bring to our mission. This role sits within our coding and appeals work, supporting accurate reimbursement, documentation integrity, and collaboration with clinical and coding teams. We offer a professional environment with normal indoor working conditions, and we are an equal opportunity employer. Applicants are asked to use their full legal name and current home address when applying, with a complete work history and supporting credentials encouraged.

last updated 40 week of 2026

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