NP Physician Advisor

J2 Integrity Solutions, LLC • Hudson, WI

7d

About The Position

The Nurse Practitioner (NP) Physician Advisor serves as a clinical advisory expert embedded within J2's middle revenue cycle consulting practice. This role bridges clinical documentation and revenue integrity by providing advanced clinical knowledge to support CDI programs, utilization management, medical necessity review, denial management, and provider education. The NP Physician Advisor functions as a trusted partner to health system clients, translating complex clinical scenarios into actionable, compliant documentation and revenue cycle outcomes. This is a people-first, outcomes-driven role for a clinician who is equally comfortable in patient care data and payer policy.

Requirements

• Active, unrestricted Nurse Practitioner license required.
• MSN, DNP, or equivalent advanced practice nursing degree.
• Minimum 3–5 years of clinical practice (acute care, hospitalist, or critical care preferred), with demonstrated experience in CDI, utilization management, or revenue cycle advisory.
• Familiarity with payer criteria tools (InterQual, MCG/Milliman, Optum ClinicalAdvisor) and major EHR platforms (Epic, Cerner) in a revenue cycle context.
• Strong working knowledge of ICD-10-CM/PCS coding, DRG methodology, CMS coverage policies, LCD/NCD guidance, and clinical documentation requirements.
• Advanced clinical judgment; revenue cycle fluency; excellent written and verbal executive communication; integrity and accountability; and collaborative leadership that elevates the people and teams around them.

Nice To Haves

• CDIP (Certified Documentation Integrity Practitioner) or CCDS (Certified Clinical Documentation Specialist) credential preferred.
• Background in denial management, clinical appeals, or utilization review nursing preferred.

Responsibilities

• Conduct clinical reviews of inpatient and outpatient medical records to identify documentation gaps, clarify diagnoses, and support accurate DRG assignment. Collaborate with CDI specialists and physicians to ensure documentation reflects the full complexity and severity of patient conditions.
• Perform clinical reviews to assess appropriateness of level of care, admission status, and continued stay criteria in alignment with payer requirements, InterQual/MCG criteria, and CMS guidelines.
• Partner with Revenue Integrity and Coding teams to review and respond to clinical denials, prepare evidence-based clinical appeal letters, and provide root cause analysis to reduce recurrence.
• Design and deliver targeted provider education on documentation best practices, CDI query processes, and regulatory requirements, building trusted relationships that promote sustainable documentation improvement.
• Develop, review, and refine clinical documentation queries in alignment with AHIMA and ACDIS query practice standards, monitoring query response rates and outcomes to improve quality, timeliness, and clinical specificity.
• Serve as a subject matter expert on clinical topics including sepsis, respiratory failure, malnutrition, chronic disease complexity, and surgical complications, guiding client teams and project leadership on clinically complex cases.
• Stay current on CMS coverage policies, LCD/NCD updates, payer-specific clinical criteria, and applicable coding guidelines (ICD-10-CM/PCS, CPT) to advise clients on compliant documentation and billing practices.
• Participate in client-facing meetings and workgroups as a clinical voice, communicating findings and recommendations in a clear, executive-appropriate format for CFOs, CMOs, and HIM leadership.
• Track and analyze KPIs including query rates, response rates, CC/MCC capture rates, denial rates, and case mix index (CMI) trends to drive continuous improvement and demonstrate measurable value.
• Function as an integrated member of J2's clinical and consulting teams, contributing to internal knowledge-sharing and peer mentoring while modeling J2's Excellence standards in every engagement.

Benefits

• At J2 Integrity Solutions, we are committed to excellence, integrity, and innovation in healthcare coding and compliance. As part of our team, you will have the opportunity to drive meaningful changes, support diverse clients, and be part of a dynamic team of professionals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level