Medical Coding Educator, MD

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.

Key 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.