Description
Role Summary
Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types.
Requirements
Core Responsibilities
- Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers.
- Ensure documentation supports coded services and identify/escalate discrepancies or gaps.
- Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits).
- Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.
Minimum Qualifications
- Credentials: CPC, CCS, RHIA, or RHIT (active).
- Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types.
- Skills & Knowledge: Strong knowledge of?CPT, HCPCS, ICD-10-CM, modifiers, and NCCI edits. Familiarity with CMS guidelines and outpatient workflows.
Client & Specialty Alignments
- Service Areas: Observation, Same Day Surgery / Ambulatory Surgery Center (ASC), Emergency Department, Ancillary services (e.g., radiology, lab, diagnostic testing), and Recurring/Outpatient Clinics.
- Specialty Expectations: Strong understanding of CPT coding across surgical and diagnostic services. Ability to code across mixed outpatient encounter types and apply payer-specific rules.
Work Model & Employment Tracks
- Work Model: 100% remote, independent, production-focused environment with collaboration across coding, audit, and client teams.
- Full-Time (FT): Standard production aligned to client or project needs.
- Part-Time / PRN / Project-Based: Flexible support for backlog, specialty coverage, or targeted initiatives.
- Note: Some positions may require evening or weekend coverage based on client needs or project scope.
Why Sage Clinical RCM
- National exposure to diverse, high-acuity health systems and specialties.
- Quality-first culture with realistic expectations (not volume-only).
- Flexible work options (FT, PT, and PRN).
- Opportunity to expand into other audit, education, and advisory services.