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Physician Advisor - CDI Experience Required

Northeast Georgia Health System -
Gainesville, GA

Apply Now

Job Details

Full-time

Qualifications

Medical License

Full Job Description

Job Category:

Physician Provider

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

The Physician Advisor for Clinical Documentation Integrity (CDI) serves as a clinical subject matter expert responsible for promoting accurate, complete, and compliant medical record documentation. This role partners with CDI, coding, and medical staff to ensure documentation accurately reflects severity of illness, risk of mortality, and complexity of care, while supporting regulatory compliance, quality reporting, and appropriate reimbursement.

Minimum Job Qualifications

Licensure or other certifications: Hold an Active unrestricted medical license in the state of Georgia. Member of the NGHS medical staff. Board certification in a primary specialty
Educational Requirements: Medical Degree, MD or DO
Minimum Experience: Five (5) - seven (7) years physician practice experience. Demonstrated clinical practice experience
Other:

Preferred Job Qualifications

Preferred Licensure or other certifications: CCDS, CDIP, or ACPA-C Medical License
Preferred Educational Requirements:
Preferred Experience: Prior Physician Advisor experience strongly preferred.
Other:

Job Specific and Unique Knowledge, Skills and Abilities

Working knowledge of clinical documentation integrity, coding principles, and working knowledge of clinical documentation integrity, coding principles, and clinical validation
Strong physician-to-physician communication and engagement skills
Ability to perform secondary clinical reviews and provide defensible clinical validation for high-risk diagnoses (e.g., sepsis, respiratory failure, encephalopathy, AKI)
Experience with physician education, query processes, and documentation improvement initiatives across multidisciplinary teams.
Ability to interpret and apply coding guidelines (ICD-10-CM, CC/MCC capture) in a clinical context
Familiarity with payer expectations and clinical validation denial trends
Ability to analyze CDI data (e.g., CMI, query rates, denial trends) and translate into actionable improvement strategies
Effective collaboration with CDI, coding, case management, and interdisciplinary teams
Familiarity with utilization management principles and ability to provide cross-coverage support, including UM reviews

Essential Tasks and Responsibilities

Provide ongoing education to physicians on documentation best practices, including accurate diagnosis capture, severity of illness, and risk of mortality
Deliver both formal presentations and targeted 1:1 education based on identified gaps and trends
Serve as a physician-to-physician resource to drive engagement and accountability in documentation practices
Perform secondary clinical reviews for complex, high-risk, or escalated CDI cases
Provide clinical validation for diagnoses with high denial risk (e.g., sepsis, acute respiratory failure, encephalopathy, AKI)
Ensure documentation accurately reflects patient acuity, clinical complexity, and resource utilization
Support development and standardization of compliant query practices
Review and provide guidance on complex, high-impact, or disputed queries
Educate providers on appropriate query responses and documentation clarification
Identify patterns in clinical validation denials and documentation vulnerabilities
Collaborate with CDI, coding, and denials teams to reduce risk and improve defensibility
Draft and support appeal letters for clinical validation and documentation-related denials
Partner with CDI, Coding, Quality, and Case Management to align documentation practices across the organization
Contribute to development of documentation guidelines, tip sheets, and educational resources
Educate CDI specialists, RNs, and interdisciplinary staff on clinical documentation and validation principles
Utilize CDI metrics (CMI, CC/MCC capture, query trends) to drive targeted improvement initiatives
Provide cross-coverage for Physician Advisor functions as needed
Perform utilization management (UM) reviews in support of operational needs and team coverage
Participate in Medical Record Utilization Review (MR-UR) Committee and provide clinical input on documentation, medical necessity, and regulatory compliance

Physical Demands

Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
Vision: Moderate, Frequently 31-65% of time
Kneeling/Stooping/Bending: Occasionally 0-30%
Standing/Walking: Occasionally 0-30%
Pushing/Pulling: Occasionally 0-30%
Intensity of Work: Frequently 31-65%
Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

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