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
Client Engagement and Project Leadership
- 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
Provider Education and Support
- 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
- Certified Risk Adjustment Coder (HCC coding)
- 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)
- Certified Risk Adjustment Coder (CRC) preferred
- 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
