Medix™
Overview
We are seeking an
experienced and dynamic Physician Advisor
to serve as a
critical liaison
between
clinical teams ,
health information management , and
care management departments . This position plays a
key role
in: Improving
clinical documentation Supporting
appropriate utilization
of hospital services The ideal candidate will bring: A
strong foundation
in
clinical practice ,
documentation integrity , and
regulatory compliance Key Responsibilities
Educate physicians
on the relationship between
clinical language ,
ICD-10 coding ,
DRG assignment , and the impact on
severity of illness (SOI) ,
risk of mortality (ROM) , and
performance metrics Conduct
one-on-one
and
departmental educational sessions
with medical staff (Internal Medicine, Surgery, Orthopedics, etc.) to improve
clinical documentation
and understanding of
coding guidelines Share
data, trends, and practice patterns
to guide documentation improvements Provide education on
medical necessity ,
appropriate utilization
of hospital services, and
regulatory compliance Clinical Documentation Integrity (CDI) Program Support
Collaborate with
CDI
and
Coding teams
to develop, optimize, and implement a
sustainable and integrated CDI program Act as a
trusted advisor
in aligning
clinical documentation
with
coding standards
and
quality metrics Identify
potential pitfalls
in CDI implementation and offer
proactive solutions
to gain
provider buy-in Perform
concurrent
and
retrospective medical record reviews , evaluating documentation against
medical necessity standards Support
case managers
and
care teams
by reviewing
admissions ,
continued stays , and issuing
non-coverage notices
when appropriate Participate in
interdisciplinary rounds
and guide
level of care determinations Assist in
denial management , including
appeals
and
peer-to-peer discussions
with payers Serve as a
liaison
between
clinical departments ,
case management ,
utilization review , and
health information management Provide
actionable insights
and education to improve
continuity of care
and
reduce readmission rates Support
care teams
in identifying
community resources
and
alternative levels of care
when appropriate Must-Have Qualifications
Graduate of an accredited medical school
with an
active New Jersey medical license Minimum of 5 years
of
clinical practice experience Familiarity with
clinical documentation improvement (CDI) ,
ICD-10 ,
DRG , and
reimbursement methodologies Strong working knowledge
of
utilization management processes
and criteria such as
MCG
or
InterQual Strong analytical, organizational, and communication skills Preferred Qualifications
Board Certification
by the
American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) Previous experience participating in
CDI
and/or
utilization review initiatives Experience in
peer-to-peer reviews
or working directly with
insurance payers Knowledge of
hospital operations ,
administrative standards , and
case management workflows Soft Skills & Attributes
Excellent verbal, written, and interpersonal communication skills Proven ability to
build rapport
with physicians and leadership to
drive collaboration Strong
presentation
and
teaching abilities Demonstrated
flexibility
and ability to
adapt
in a dynamic healthcare environment Effective
multitasking ,
priority setting , and
problem-solving
abilities Results-driven
with a focus on
achieving outcomes
#J-18808-Ljbffr
We are seeking an
experienced and dynamic Physician Advisor
to serve as a
critical liaison
between
clinical teams ,
health information management , and
care management departments . This position plays a
key role
in: Improving
clinical documentation Supporting
appropriate utilization
of hospital services The ideal candidate will bring: A
strong foundation
in
clinical practice ,
documentation integrity , and
regulatory compliance Key Responsibilities
Educate physicians
on the relationship between
clinical language ,
ICD-10 coding ,
DRG assignment , and the impact on
severity of illness (SOI) ,
risk of mortality (ROM) , and
performance metrics Conduct
one-on-one
and
departmental educational sessions
with medical staff (Internal Medicine, Surgery, Orthopedics, etc.) to improve
clinical documentation
and understanding of
coding guidelines Share
data, trends, and practice patterns
to guide documentation improvements Provide education on
medical necessity ,
appropriate utilization
of hospital services, and
regulatory compliance Clinical Documentation Integrity (CDI) Program Support
Collaborate with
CDI
and
Coding teams
to develop, optimize, and implement a
sustainable and integrated CDI program Act as a
trusted advisor
in aligning
clinical documentation
with
coding standards
and
quality metrics Identify
potential pitfalls
in CDI implementation and offer
proactive solutions
to gain
provider buy-in Perform
concurrent
and
retrospective medical record reviews , evaluating documentation against
medical necessity standards Support
case managers
and
care teams
by reviewing
admissions ,
continued stays , and issuing
non-coverage notices
when appropriate Participate in
interdisciplinary rounds
and guide
level of care determinations Assist in
denial management , including
appeals
and
peer-to-peer discussions
with payers Serve as a
liaison
between
clinical departments ,
case management ,
utilization review , and
health information management Provide
actionable insights
and education to improve
continuity of care
and
reduce readmission rates Support
care teams
in identifying
community resources
and
alternative levels of care
when appropriate Must-Have Qualifications
Graduate of an accredited medical school
with an
active New Jersey medical license Minimum of 5 years
of
clinical practice experience Familiarity with
clinical documentation improvement (CDI) ,
ICD-10 ,
DRG , and
reimbursement methodologies Strong working knowledge
of
utilization management processes
and criteria such as
MCG
or
InterQual Strong analytical, organizational, and communication skills Preferred Qualifications
Board Certification
by the
American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) Previous experience participating in
CDI
and/or
utilization review initiatives Experience in
peer-to-peer reviews
or working directly with
insurance payers Knowledge of
hospital operations ,
administrative standards , and
case management workflows Soft Skills & Attributes
Excellent verbal, written, and interpersonal communication skills Proven ability to
build rapport
with physicians and leadership to
drive collaboration Strong
presentation
and
teaching abilities Demonstrated
flexibility
and ability to
adapt
in a dynamic healthcare environment Effective
multitasking ,
priority setting , and
problem-solving
abilities Results-driven
with a focus on
achieving outcomes
#J-18808-Ljbffr