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