Clin Doc Integrity Physician Advisor

Our promise to you:

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Job Description Summary:

The Physician Advisor for CDI is a board-certified physician who serves as the clinical leader and liaison between the CDI department, physicians, and coding/billing teams. This role is responsible for ensuring that clinical documentation accurately reflects the complexity of patient care, supports optimal reimbursement, and complies with regulatory standards. The ideal candidate will have a strong background in clinical practice, excellent communication skills, and a passion for improving documentation quality across the organization. This role offers a unique opportunity to leverage clinical expertise to drive improvements in documentation quality and revenue optimization while playing a pivotal role in enhancing patient care outcomes.

Job Description:

• Analyze patient medical records to identify areas where documentation needs improvement, including missing diagnoses, unclear clinical findings, or inconsistencies in treatment plans to ensure accurate representation of diagnoses, procedures, and severity of illness.
• Provide clinical expertise and guidance to CDI specialists and coders in clarifying documentation issues.
• Identify opportunities to enhance documentation to support the level of care provided.
• Participate in interdisciplinary case reviews and CDI meetings to drive process improvements.
• Work collaboratively with medical staff to ensure documentation accurately reflects the severity of illness, risk of mortality, and complexity of care.
• Educate physicians and advanced practice providers (APPs on best practices in clinical documentation and coding compliance.
• Coordinate with GME to provide focused education on early development of documentation best practices to incoming residents and fellows.
• Serve as a resource for providers regarding clinical terminology, coding nuances, and regulatory requirements.
• Provide ongoing feedback and coaching to enhance documentation practices and compliance.
• Conduct physician outreach sessions to address common documentation issues and promote awareness of CDI initiatives.
• Assist in the development and refinement of compliant physician queries to attending physicians when clarification is needed on clinical details to ensure accurate coding.
• Interpret physician responses and collaborate with the CDI team to resolve any documentation discrepancies.
• Provide feedback on query responses and encourage a culture of accurate, thorough documentation.
• Participate in mortality reviews, DRG downgrade denials management, and clinical validation processes.
• Ensure clinical documentation aligns with coding guidelines, CMS regulations, and hospital policies.
• Support hospital initiatives related to compliance, audit readiness, and quality reporting metrics.
• Participate in CDI-related committees and performance improvement initiatives.
• Collaborate with quality teams on initiatives related to hospital-acquired conditions (HACs, patient safety indicators (PSIs, and mortality reviews.
• Contribute to hospital-wide efforts to improve revenue integrity and performance benchmarks.
• Stay abreast of changes in coding standards (ICD-10-CM, CPT, CMS guidelines, and DNV requirements, and communicate their implications to clinical teams.
• Monitor and analyze CDI metrics such as LOS and GMLOS variance, Case Mix Index (CMI, and MCC/CC capture rate.
• Prepare regular reports on CDI outcomes, including recommendations to optimize reimbursement and clinical quality.
• Collaborate with hospital leadership to implement CDI strategies that improve documentation and patient outcomes.
• Performs other duties as assigned.

Knowledge, Skills, and Abilities:

• Demonstrated interest or experience in clinical documentation improvement, coding, or revenue cycle management. [Required]

• Knowledge of CDI principles, coding guidelines (ICD-10-CM, ICD-10-PCS, MS-DRG assignment, and CMS regulations. [Required]

• Excellent analytical, communication, and interpersonal skills. [Required]

• Ability to work collaboratively with diverse teams, including physicians, CDI professionals, and hospital administration. [Required]

• Familiarity with electronic health record (EHR systems and CDI software [Preferred]• Advanced training or certification in CDI, medical coding, or healthcare compliance. [Preferred]

• Experience in conducting educational programs for clinical staff. [Preferred]

• Experience with data analysis and performance improvement initiatives. [Preferred]

• Certification by ABQAURP or ACPA [Preferred]

Education:

• Doctorate [Required]

• Master's [Preferred]

Field of Study:

• Graduate of an accredited Medical School

• Master's in Business or Healthcare Administration

Work Experience:

• 3+ years of experience [Required]

• Experience working directly with a CDI program [Preferred]

Additional Information:

• N/A

Licenses and Certifications:

• Medical Doctor (MD [Required] OR Doctor of Osteopathic Medicine (DO [Required]

• Healthcare Quality and Management Certification (HQCM [Preferred]

• Basic Life Support (BLS [Preferred]

Physical Requirements: (Please click the link below to view work requirements

• Physical Requirements - https://tinyurl.com/23km2677

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America

Address:

770 W GRANADA BLVD

City:

ORMOND BEACH

State:

Florida

Postal Code:

32174

Background Screening Requirement (Florida Law

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida's background screening requirements at the Florida Care Provider Background Screening Clearinghouse:

https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.