Practice Transformation Specialist
5 days ago
Athens
Job Description About Us PBACO supports independent physicians with the tools, services and incentives to thrive - without giving up control. We collaborate with like-minded hospital systems and care centers to create a seamless, integrated experience that improves outcomes and lowers costs. You're not just a participant - you're our partner. Position Overview The Healthcare Practice Transformation Specialist will serve as a key liaison between physician practices and our organization. This role combines EHR training, clinical documentation review, risk adjustment coding, and billing support. The ideal candidate will be a Certified Professional Coder (CPC) with strong experience in Medicare, risk adjustment, and healthcare analytics. Key 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., • Certified Professional Coder (CPC) or equivalent certification., • Experience with Medicare Advantage (MA) plans, risk adjustment, or insurance companies., • High school diploma or GED required; associate’s or bachelor’s degree preferred., • 2+ years of medical coding, billing, or risk adjustment experience., • Proficiency in EHR systems (Athena, eClinicalWorks, or similar) and MS Office Suite (Excel expertise strongly preferred)., • Strong knowledge of ICD-10, CPT, and HCPCS coding and regulatory compliance., • Excellent communication and training skills for working directly with providers and staff. This position requires 50-75% local travel and is eligible for a car allowance. BACO supports independent physicians with the tools, services, and incentives to thrive—without giving up control. We collaborate with like-minded hospital systems and care centers to create a seamless, integrated experience that improves outcomes and lowers costs. You’re not just a participant—you’re our partner. PBACO supports independent physicians with the tools, services, and incentives to thrive—without giving up control. We collaborate with like-minded hospital systems and care centers to create a seamless, integrated experience that improves outcomes and lowers costs. You’re not just a participant—you’re our partner. PBACO supports independent physicians with the tools, services, and incentives to thrive—without giving up control. We collaborate with like-minded hospital systems and care centers to create a seamless, integrated experience that improves outcomes and lowers costs. You’re not just a participant—you’re our partner.