Job Summary:
The PHI Physician Educator, MD is responsible for providing physician-focused education on Evaluation & Management (E/M) coding, Medical Decision Making (MDM), and coding compliance. This role serves as a trusted clinical and coding resource, utilizing audit findings and industry guidelines to improve documentation quality, coding accuracy, regulatory compliance, and reimbursement integrity.
Responsibilities:
- Deliver education and training on E/M documentation, MDM requirements, medical necessity, ICD-10, and CPT coding guidelines.
- Conduct provider education based on coding audits, documentation trends, and identified compliance risks.
- Educate physicians on documentation supporting appropriate E/M levels, moderate versus high-complexity MDM, prescription drug management, and risk assignment.
- Provide specialty-specific guidance to improve documentation accuracy and coding compliance.
- Utilize de-identified audit examples to illustrate documentation strengths and improvement opportunities.
- Collaborate with Coding, Compliance, and Operational teams to address coding disputes and documentation concerns.
- Serve as a subject matter expert and resource for physicians regarding clinical documentation and coding best practices.
Qualifications:
- Doctor of Medicine (MD) with an active and unrestricted medical license.
- Required certification: AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist-Physician Based (CCS-P).
- Strong knowledge of E/M coding guidelines, Medical Decision Making (MDM), ICD-10-CM, CPT, and documentation requirements.
- Experience in physician education, clinical documentation improvement (CDI), coding compliance, or medical auditing preferred.
- Excellent communication, presentation, and stakeholder engagement skills.
