Professional Fee Auditor – ProFee

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Sage Clinical RCM, LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2024

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Sage Clinical RCM is a healthcare revenue cycle management company that combines proprietary technology with clinical and financial expertise to provide end-to-end RCM solutions—from patient access through financial close. The firm offers advisory services, revenue cycle management operations, technology adoption (including clinical documentation improvement and autonomous coding), workforce augmentation (coding, documentation, RCM, physician advisory), and analytics-driven platforms (Sage IQ: Validity and VERO) that use automation and AI to unify coding, documentation, vendor performance, compliance, and financial reporting for healthcare organizations.

📋 Description

• Responsible for reviewing professional fee (ProFee) physician coding to validate accuracy, compliance, and documentation support. • This role identifies risks, ensures coding consistency, and provides clear feedback to improve overall coding quality. • Perform retrospective and/or concurrent audits of professional fee coding. • Validate CPT, HCPCS, ICD-10-CM code selection, and modifier usage. • Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies. • Identify trends, risks, and opportunities for coding improvement. • Provide clear, actionable audit feedback and education to coding staff. • Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.

🎯 Requirements

• Credentials: CPC, CPMA, CCS, RHIA, or RHIT (active). • Experience: Minimum 3+ years professional fee auditing experience and at least 2 years of auditing experience. In lieu of auditing experience, 7+ years of coding experience is required. Prior coding experience strongly preferred. • Experience auditing physician services (hospital-based or large practice preferred physician services preferred). • Strong knowledge of RVU and CPT/HCPCS, ICD-10-CM, modifiers, and NCCI edits. • Strong written communication skills and high attention to detail.

🏖️ Benefits

• 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.