Job Summary The Coder's primary job function is to certify accurate billing for professional services and hospital procedures. This is accomplished through review of clinical encounters, confirming correct use of diagnosis and procedural codes and application of appropriate modifiers and CCI edits. The Coder provides education to providers to ensure proper completion of the medical record. Job Specific Competencies 1. Reviews clinical encounters presented via electronic lists to ensure proper submission of services prior to billing. a. Edits and corrects diagnosis and procedural codes and applies modifiers and CCI edits as required according to coding guidelines and department policy. b. Effectively utilizes coding software and/or books to confirm coding accuracy. c. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. 2. Receives and reviews paper fee slips for hospital services and ensures proper coding of diagnosis and procedural codes. a. Applies modifiers and CCI edits as required and supported by the documented medical record. Posts charges for final billing. b. Verifies referring provider, rendering provider, department and other critical data elements are accurate prior to submission of completed coding. 3. Utilizing approved methods, communicates incorrect application of procedure or diagnosis codes or incomplete medical documentation to providers. a. Reports all unresolved non-compliant coding issues immediately upon discovery, as dictated by department or organizational policy. b. Works with providers and clinical support staff to resolve coding and documentation concerns. 4. Meets on a regular basis with providers and clinical staff (for their assigned specialties) for the purpose of educating them on coding rule changes and/or coding trends and to answer coding questions a. Participates with educational activities with clinical departments, corporate compliance, etc. to ensure lines of communication among departments remains #J-18808-Ljbffr