Provider Performance

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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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