Note: The job is a remote job and is open to candidates in USA. Enjoin is a company dedicated to improving healthcare documentation and compliance. The Clinical Denials Analyst is responsible for reviewing clinical denials, developing appeal strategies, and collaborating with physicians to enhance revenue integrity outcomes.
Responsibilities
- Perform comprehensive reviews of medical records and clinical documentation to determine root causes of denials
- Develop and execute effective appeal strategies based on clinical criteria, coding guidelines, and payer policies
- Draft clear, concise, and evidence-based appeal letters using clinical documentation and supporting literature
- Collaborate with Enjoin physicians to review and finalize appeals prior to submission
- Analyze denial trends and provide actionable insights to Advisory teams and leadership
- Partner with internal stakeholders to improve CDI workflows and reduce denial rates
- Ensure compliance with HIPAA and maintain strict confidentiality of patient information
- Maintain access to client systems and ensure timely, accurate completion of assigned work
- Contribute to process improvements and best practices to enhance denial management outcomes
Skills
- CCS, RHIT, RHIA, CDIP, or CCDS credential
- 7+ years of acute inpatient coding, auditing or CDI experience
- Strong knowledge of ICD-10-CM/PCS coding and clinical documentation standards
- Experience reviewing clinical denials, payer policies, and clinical validation criteria
- Strong analytical and critical-thinking skills with excellent attention to detail
- Strong written communication skills with experience developing clear, clinically supported appeals
- Experience working in EHR systems such as Epic, Cerner, or Meditech
- Ability to work independently in a remote environment while effectively managing priorities and deadlines
- Proficiency in Microsoft Office, including Word and Excel
- RN or MD
- Healthcare consulting experience
- Experience working across clinical, coding, CDI, and operational teams
Benefits
- Comprehensive medical, dental, and vision insurance
- 401(k) with company match
- Generous paid time off plus eight paid holidays
- 100% remote work environment with company-provided equipment
- Professional development, continuing education, leadership training, and internal career growth opportunities
- Complimentary annual CEUs
- Access to advanced coding education and learning resources
- Employee wellness resources and discount programs
- Referral bonus opportunities
- White glove onboarding designed to set you up for success
- A collaborative, people-first culture proudly recognized as a Great Place to Work® Certified organization
Company Overview