Medical Coder

Job Summary:

Maple City Health Care Center (MCHCC) is a Federally Qualified Health Center dedicated to improving our community’s health by making quality comprehensive healthcare accessible to all. We strive for a healthy community where everyone is cared for.

The Medical Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for medical, dental, and behavioral health services in compliance with federal, state, payer, and HRSA/FQHC requirements. This role supports timely and compliant billing, reimbursement optimization, and audit readiness.

Essential Duties and Responsibilities

Essential Duties and Responsibilities

• Review provider documentation to ensure completeness, accuracy, and compliance with coding guidelines.

• Assign appropriate ICD-10-CM, CPT, and HCPCS codes for:

o Primary care services

o Behavioral health services

o Dental services (as applicable)

• Ensure coding supports medical necessity, scope of practice, and payer requirements

• Apply correct modifiers, place of service codes, and diagnosis sequencing

• Identify documentation deficiencies and communicate clarification needs to providers

• Maintain compliance with:

o CMS, Medicare, Medicaid, and commercial payer rules

o HRSA and FQHC billing requirements

o OIG compliance and fraud, waste, and abuse prevention

• Assist with claim edits, denials, and coding-related appeals

• Participate in internal and external coding audits and implement corrective actions

• Stay current with coding updates, annual code set changes, and regulatory guidance

• Support productivity, accuracy, and quality benchmarks established by MCHCC

• Maintain confidentiality and compliance with HIPAA regulations