Healthcare Practice Transformation & Coding Specialist

Palm Beach Accountable Care Organization; Stafford Township (NJ); On-site; USD 70,000 - 110,000; Full time

Job summary

Palm Beach Accountable Care Organization seeks a Healthcare Practice Transformation Specialist to bridge physician practices with our organization, focusing on EHR training, clinical documentation review, risk adjustment coding, and billing support. The ideal candidate is a CPC with Medicare risk adjustment expertise and healthcare analytics experience.

The role involves supporting physician networks, configuring EHR systems, training staff on compliance and workflows, and performing audits to

Qualifications

• Certified Professional Coder (CPC) or equivalent certification.
• Experience with Medicare Advantage plans, risk adjustment, or insurance companies.
• 2+ years of medical coding, billing, or risk adjustment experience.
• Proficiency in EHR systems (Athena, eClinicalWorks, or similar) and MS Excel.

Responsibilities

• Manage and support a physician network to ensure successful EHR integration and troubleshooting.
• Consult with medical practices to analyze workflows, configure EHR systems, and develop customized training plans.
• Train physicians and office staff on EHR best practices, regulatory compliance, and specialty-specific workflows.
• Review clinical documentation and medical records to ensure accurate ICD-10, CPT, and HCPCS coding for risk adjustment and quality gap closure.
• Conduct coding audits and provide education to providers on compliant documentation.
• Monitor payer guidelines and coding updates, especially for Medicare Advantage and accountable care organizations.
• Assist with billing, claims submission, payment posting, and collections as needed.
• Perform financial analysis and reporting using Microsoft Excel (pivot tables, trend analysis).
• Analyze denial reports, identify trends, and recommend corrective actions.
• Support quality improvement initiatives by ensuring accurate coding for chronic conditions.
• Answer patient billing and claims questions in a professional and clear manner.
• Maintain compliance with HIPAA, coding regulations, and company policies.
• Participate in special projects, audits, and continuous process improvement initiatives.

Skills

EHR training

Risk adjustment

Healthcare analytics

Regulatory compliance

Communication skills

Education

High school diploma or GED

Associate's or Bachelor's degree preferred

Tools

Athena

eClinicalWorks

Excel

Job description

Palm Beach Accountable Care Organization seeks a Healthcare Practice Transformation Specialist to bridge physician practices with our organization, focusing on EHR training, clinical documentation review, risk adjustment coding, and billing support. The ideal candidate is a CPC with Medicare risk adjustment expertise and healthcare analytics experience.

The role involves supporting physician networks, configuring EHR systems, training staff on compliance and workflows, and performing audits to