Professional Fee Coder (ProFee) (Remote | FT, PT, or PRN)
Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments. Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements: Core Responsibilities (Sage Standards)
- Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes
- Ensure documentation supports coded services and identify discrepancies
- Apply appropriate modifiers, NCCI edits, and payer-specific coding rules
- Ensure compliance with CMS, AMA, and payer guidelines
- Maintain =95% coding accuracy and meet established productivity standards
- Identify documentation gaps and escalate for clarification when needed
- Participate in quality reviews, audits, and ongoing coding education
Minimum Qualifications (Sage Requirements)
- Credential: CPC, CCS-P, RHIA, or RHIT (active and in good standing)
- Experience:
- Minimum 2–3+ years professional fee coding experience
- Experience in hospital-based or physician practice environments preferred
- Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, and NCCI edits
- Familiarity with payer policies and coding guidelines
- Ability to work independently in a remote environment
- High attention to detail with consistent quality performance
Work Model
- 100% remote
- Independent, production-focused environment with defined quality expectations
- Collaboration with coding, audit, and client teams
Employment Tracks Full-Time (FT):
- Standard weekday coverage aligned to client volumes
PRN / Part-Time:
- Flexible scheduling to support backlog, specialty needs, or project-based work
Specialty Alignment (Core to Role Placement) Coders are aligned to engagements based on demonstrated specialty experience. One or more specialties may be required. Surgical Specialties (Highest Complexity)
- Cardiothoracic Surgery
- Vascular Surgery
- General Surgery
- Orthopedic Surgery
- Neurosurgery
- Surgical Oncology
- Plastics / Reconstructive
- Colorectal, Urology, ENT
Additional Expectations:
- Strong experience reviewing operative reports and procedural documentation
- Advanced modifier application (e.g., co-surgeon, assistant, multiple procedures)
- Deep understanding of NCCI edits and bundling rules
- Ability to independently code complex surgical cases
Medical & E/M-Based Specialties
- Internal Medicine / Family Medicine
- Cardiology (E&M and/or procedural)
- Gastroenterology
- Pulmonary, Nephrology, Endocrinology
- Infectious Disease, Rheumatology
- Neurology, Psychiatry
Additional Expectations:
- Strong knowledge of E&M leveling and documentation requirements
- Accurate capture of chronic conditions and medical necessity
- Ability to validate completeness and appropriateness of provider documentation
Diagnostic & Ancillary Specialties
- Radiology
- Pathology
- Anesthesiology
- Radiation Oncology
Additional Expectations:
- Understanding of specialty-specific coding structures
- Accurate use of modifiers specific to professional services (e.g., component billing)
- Consistency in applying coding conventions across high-volume workflows
General Client Expectations
- Ability to code independently within assigned specialty or specialties
- Consistent delivery of =95% coding quality and aligned productivity standards
- Adaptability to varying client workflows, systems, and documentation practices
- Effective communication with internal teams and client stakeholders
Why Sage Clinical RCM
- Exposure to diverse specialties and complex health system environments
- Flexible work options (FT, PT, and PRN)
- Quality-driven culture with realistic expectations
- Opportunity to expand into QA, audit, education, and advisory services