Professional Fee Coder (ProFee) (Remote | FT, PT, or PRN)

Job Description

Job Description

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.

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