Physician Education and Documentation Improvement Specialist (PEDIS)

Job Title: Physician Education and Documentation Improvement Specialist (PEDIS)

Reports to: Coding Director

Summary: The Physician Education and Documentation Improvement Specialist (PEDIS) serve as a key resource for coding quality, provider education, and documentation improvement initiatives. This role acts as the primary liaison between physicians, coding staff, and revenue cycle leadership to support accurate coding, compliant documentation, and optimal charge capture. Under the direction of the Coding Director, PEDIS leads providers auditing activities, analyzes coding quality trends, and responds to data and information requests related to coding performance. PEDIS collaborates with our coding team to identify documentation and coding opportunities, delivering targeted education and feedback to both providers and coders.

Through ongoing monitoring, reporting, and engagement with clinical departments, the role promotes adherence to coding guidelines, organizational policies, and regulatory requirements. PEDIS also partners directly with physicians to enhance the clarity, completeness, and specificity of clinical documentation through formal training, one-on-one education, and department-level presentations. These efforts support improved documentation quality, reduce reliance on full coder review, and strengthen overall coding accuracy and efficiency across the organization.

Essential Duties and Responsibilities:

• Conduct coding accuracy audits for providers across financial divisions focusing on providers below MSP’s Median E/M distribution benchmark. Prioritize review, drive audit selection and ensure completion of targeted providers audits each review quarter
• Deliver post audit findings to WWT leadership, UIH department leaders and through 1:1 meeting with audited providers on documentation practices
• Managed ongoing re-audit of previously audited providers to assess improvement and/or educational opportunities
• Utilize insights from provider audits to educate coding staff on emerging trends to reinforce best practices, reduce errors and mitigate compliance risk.
• Conduct quarterly provider tier review analysis on provider coding accuracy and disseminate data to UIH department leadership team
• Collaborates with leadership, physicians and key stakeholders to promote clinically appropriate, complete and compliant documentation. Providing ongoing education on coding, reimbursement, and performance improvement opportunities to support accurate reimbursement
• Respond to Ad hoc audit request from UI departments or providers
• Assist with management of the Coding QA Inbox to monitor inquiry from Coders
• Conduct Coding onboarding education training to new providers
• Develop present educational seminar for bi-annual MSP lunch and learn
• Serves as a subject matter expert and educational resource. Demonstrates ongoing commitment to professional development by staying current with clinical documentation standards and regulatory requirements through workshops, conferences and or in services and maintains records of participation
• This position will require travel to UI Hospital campus
• Other duties as assigned

Education/Experience:

Bachelor’s Degree preferred or equivalent combination of education, training and experience.   Demonstrated expertise in physician coding and billing.  Minimum three to five years of experience in physician billing and directly related healthcare revenue cycle experience required. Previous experience working directly with physicians required. Must be well versed in regulatory requirements for medical record documentation. Exceptional professionalism, written/verbal communication and strong presentation and public speaking skills are essential.

Education/Licensure/Certifications:

RHIA, RHIT, CPC or CCS-P with at least three years certified coding experience in a physician-based setting

 

Knowledge, Skills & Abilities

• Knowledge – knowledge of medical terminology, coding and office procedures.
• Communication communicates clearly and concisely, verbally and in writing.
• Persistence – comfortable pursuing, rebutting and escalating issues as appropriate.
• Goal-oriented – holds him/herself accountable to achieving shared professional and personal goals.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Interpersonal skills – establishing and maintaining effective working relationships with employees, patients and external parties.
• PC skills - demonstrates high proficiency in Microsoft Office applications, especially Microsoft Excel, and others as required.
• Writing skills –advanced writing skills with ability to present a compelling argument, punctuate properly, spell correctly and transcribe accurately.