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. Requirements 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 TracksFull-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