Medical Coder

Description

Job Summary:

CAPS & Maple Cityis 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

Requirements

Required Qualifications

High school diploma or equivalent, associate’s degree + preferred

· Minimum 1 year of medical coding experience, preferably in:

• Primary care
• multi-specialty environment
• ·Strong working knowledge of:
• ICD-10-CM
• CPT
• HCPCS Level II

· Experience with electronic medical record (EMR) systems

· Understanding of Medicare and Medicaid billing rules

· Strong organizational skills with attention to detail

• Experienced in Microsoft office and other EMR software
• Self-motivated, critical thinking and ability to multitask
• Bilingual preferred but not necessary (English/Spanish) 

· Demonstrates effective interpersonal skills.

Required Certifications (One or More Preferred)

• · CPC (Certified Professional Coder)
• · CCS (Certified Coding Specialist)
• · CCS-P (Physician-based)

Skills and Competencies

· Ability to interpret clinical documentation

· Effective written and verbal communication

· Ability to work independently and meet deadlines

· Commitment to compliance and ethical standards

Physical and Work Requirements

· Prolonged periods sitting at a desk and working on a computer

· Must be able to lift up to 15 pounds at times

· Reasonable accommodation may be provided to enable individuals with disabilities to perform the essential functions of this work

· We are required by federal law to verify identity and eligibility to work in U.S.

What We Offer:

· Competitive salary and benefits package (Retirement plan, health insurance, childcare reimbursement)

· Opportunities for professional development and growth

· A supportive and inclusive workplace culture

· The chance to make a meaningful impact on the healthcare experience in our community

How to Apply:

To apply for this position, please submit your resume and a cover letter that highlights your experience and how your unique background will contribute to our team. We encourage candidates from all backgrounds to apply.

Equal Opportunity Employer:

CAPS & Maple City is an equal opportunity employer, and we are committed to creating a diverse and inclusive culture. We do not discriminate based on sex, race, gender identity, sexual orientation, religion, national origin, age, veteran status, or any other protected status under the law. We celebrate diversity and are committed to creating an inclusive environment for all employees and the patients we serve.

Compliance Statement

The Medical Coder must adhere to all MCHCC policies, including compliance, confidentiality, HIPAA, fraud and abuse prevention, and code of conduct standards.

Equal Opportunity Employer:

CAPS & Maple City is an equal opportunity employer, and we are committed to creating a diverse and inclusive culture. We do not discriminate on the basis of sex, race, gender identity, sexual orientation, religion, national origin, age, veteran status, or any other protected status under the law. We celebrate diversity and are committed to creating an inclusive environment for all employees and the patients we serve.