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