Description
Role Summary
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, supporting single-specialty or multi-specialty engagements.
Core Responsibilities
- Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes.
- Ensure documentation supports coded services and identify/escalate discrepancies or gaps.
- Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including AMA and NCCI edits).
- Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.
Requirements
Minimum Qualifications
- Credentials: 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.
- Skills & Knowledge: Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, and payer policies.
Client & Specialty Alignments
- Evaluation & Management (E/M) Services: Requires strong knowledge of E/M leveling guidelines, accurate capture of chronic conditions, and validation of medical inpatient encounters.
- Minor & Major Procedure Coding: Requires the ability to independently review documentation and accurately assign CPT/HCPCS codes for both minor and major procedures, including appropriate modifier application and adherence to coding guidelines.
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.