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Provider Performance & Coding Consultant
Provider Performance & Coding Consultant
Transform healthcare. Empower providers. Improve lives.
Position Description
Are you passionate about improving healthcare delivery and helping providers succeed in a changing landscape? As a Provider Performance & Coding Consultant, you play a key role in guiding medical practices toward better performance, accurate coding, and optimized workflows. You will help providers transition from traditional fee-for-service models to value-based care, ensuring they deliver high-quality care while maintaining financial health.
This is a hands-on, client-facing role where you lead projects, educate providers, and support healthcare transformation. You'll work with a diverse team of professionals who are committed to making a difference in patient outcomes and provider success.
Job Functions and Duties
* Manage the full lifecycle of client projects, from kickoff to completion
* Develop customized work plans with clear goals, timelines, and deliverables
* Coordinate resources and activities across multiple practices
* Ensure projects meet quality standards and deadlines
Client Engagement and Project Leadership
* Train providers and staff on documentation, coding, and billing best practices
* Prepare practices for audits and regulatory reviews
* Present performance insights and improvement strategies
* Serve as a trusted advisor on healthcare regulations and payer requirements
Workflow Optimization and Technology Integration
* Act as liaison between practices and electronic health record (EHR) vendors
* Support EHR adoption, configuration, and optimization
* Recommend workflow improvements to enhance efficiency and compliance
* Help practices align with MIPS, Promoting Interoperability, and other programs
Regulatory and Program Guidance
* Stay current with healthcare regulations, trends, and payer programs
* Educate clients on changes affecting coding, billing, and performance metrics
* Support practices in meeting public health agency requirements
Reporting and Communication
* Create and maintain weekly/monthly performance dashboards and reports
* Communicate project updates and recommendations clearly and professionally
* Collaborate with supervisors to review goals, progress, and challenges
Business Development and Revenue Support
* Assist with client acquisition and retention strategies
* Support Fee-for-Service consulting and other revenue-generating activities
* Promote services and solutions that enhance client performance
Knowledge, Skills, and Abilities
Required Knowledge and Experience
* Medical coding experience (certification from AAPC or AHIMA required)
* HEDIS knowledge and Medicare Advantage familiarity
* Experience with EHR systems and chart auditing
* Understanding of healthcare revenue cycles and quality improvement methods
Preferred Knowledge and Experience
* Experience with practice transformation or process improvement
* Familiarity with Patient-Centered Medical Home models
* Knowledge of MIPS, Promoting Interoperability, and clinical operations
* Bachelor's degree in Health Informatics, Health Services Administration, or related field
Skills and Abilities
* Strong project management and organizational skills
* Ability to work independently and manage multiple priorities
* Excellent written and verbal communication skills
* Comfortable with public speaking and client presentations
* Proficient in Microsoft Office (Outlook, Excel, PowerPoint, Word)
* Self-motivated, proactive, and adaptable in a fast-paced environment
* Knowledge of medical terminology and ability to apply it appropriately
Licenses, Certifications, and Legal Requirements
* Certified Professional Coder (CPC), Certified Coding Specialist (CCS)
* Must meet all legal requirements for healthcare consulting roles
Work Schedule
* Monday to Friday, 8:00 AM – 5:00 PM
* Occasional variations may include early mornings, evenings, or overnight travel based on client location/needs
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