Clinical Denials Analyst at Enjoin
United States
<h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">About Enjoin</span></strong></span></h1><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">At Enjoin, your work makes a meaningful impact.</span></span></p><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">We partner with hospitals and health systems nationwide to improve documentation accuracy, strengthen compliance, and ensure patient care is accurately represented. By combining deep clinical and coding expertise with advanced technology, our team delivers measurable results that support better patient outcomes and appropriate reimbursement.</span></span></p><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">We're committed to building a collaborative, high-performing culture where people are supported, challenged, and empowered to grow. With more than 200 professionals and a national network of clinical experts, you'll work alongside talented colleagues who value collaboration, innovation, clinical excellence, and a shared commitment to delivering exceptional results.</span></span></p><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Proudly <strong>Great Place to Work® Certified</strong> for three consecutive years, we're dedicated to creating an environment where our people can do their best work while making a real difference.</span></span></p><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Job Summary</span></strong></span></h1><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">The <strong>Clinical Denials Analyst (CDA)</strong> is responsible for reviewing and managing clinical denials through in-depth medical record analysis, clinical validation, and application of coding guidelines. This role focuses on identifying appeal opportunities, drafting evidence-based appeal letters, and driving improved revenue integrity outcomes for clients.</span></span><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Working closely with physicians and Advisory teams, the CDA combines clinical expertise, coding knowledge, and data analysis to uncover denial trends, strengthen documentation practices, and support continuous improvement in denial prevention strategies.</span></span></p><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">What You'll Do</span></strong></span></h1><ul><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Perform comprehensive reviews of medical records and clinical documentation to determine root causes of denials</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Develop and execute effective appeal strategies based on clinical criteria, coding guidelines, and payer policies</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Draft clear, concise, and evidence-based appeal letters using clinical documentation and supporting literature</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Collaborate with Enjoin physicians to review and finalize appeals prior to submission</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Analyze denial trends and provide actionable insights to Advisory teams and leadership</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Partner with internal stakeholders to improve CDI workflows and reduce denial rates</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Ensure compliance with HIPAA and maintain strict confidentiality of patient information</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Maintain access to client systems and ensure timely, accurate completion of assigned work</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Contribute to process improvements and best practices to enhance denial management outcomes</span></span></li></ul><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Qualifications</span></strong></span></h1><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;"><strong>Required</strong></span></span><ul><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">CCS, RHIT, RHIA, CDIP, or CCDS credential</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">7+ years of acute inpatient coding, auditing or CDI experience</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Strong knowledge of ICD-10-CM/PCS coding and clinical documentation standards</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Experience reviewing clinical denials, payer policies, and clinical validation criteria</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Strong analytical and critical-thinking skills with excellent attention to detail</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Strong written communication skills with experience developing clear, clinically supported appeals</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Experience working in EHR systems such as Epic, Cerner, or Meditech</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Ability to work independently in a remote environment while effectively managing priorities and deadlines</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Proficiency in Microsoft Office, including Word and Excel</span></span></li></ul><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;"><strong>Preferred</strong></span></span><ul><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">RN or MD</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Healthcare consulting experience</span></span></li><li><span style="font-family:Arial, Helvetica, sans-serif;"><span style="font-size:14px;">Experience working across clinical, coding, CDI, and operational teams</span></span></li></ul><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Work Environment & Expectations</span></strong></span></h1><ul><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Fully remote, full-time position (40 hours per week)</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Monday through Friday during regular business hours</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Company-issued equipment provided</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Dedicated secure home workspace required</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">High-speed internet connection required</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Strict adherence to HIPAA Privacy and Security requirements</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Ability to work independently while maintaining productivity and quality expectations</span></span></li></ul><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Why Enjoin</span></strong></span></h1><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">At Enjoin, we believe exceptional people deserve exceptional support. That's why we offer a comprehensive total rewards package designed to help our team members thrive professionally and personally.</span></span></p><ul><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Comprehensive medical, dental, and vision insurance</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">401(k) with company match</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Generous paid time off plus eight paid holidays</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">100% remote work environment with company-provided equipment</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Professional development, continuing education, leadership training, and internal career growth opportunities</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Complimentary annual CEUs</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Access to advanced coding education and learning resources</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Employee wellness resources and discount programs</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Referral bonus opportunities</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">White glove onboarding designed to set you up for success</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">A collaborative, people-first culture proudly recognized as a Great Place to Work® Certified organization</span></span></li></ul><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Hiring Process</span></strong></span></h1><ul><li><span style="font-size:14px;">Multiple-choice assessment</span></li><li><font face="Arial, Helvetica, sans-serif"><span style="font-size:14px;">Phone call with a Talent Acquisition Specialist</span></font></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Video interview with the Hiring Manager (must be on camera)</span></span></li><li><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Panel interview with the Denials Team (must be on camera)</span></span></li></ul><h1><span style="font-size:18px;"><strong><span style="font-family:Arial, Helvetica, sans-serif;">Equal Employment Opportunity</span></strong></span></h1><p><span style="font-size:14px;"><span style="font-family:Arial, Helvetica, sans-serif;">Enjoin is committed to fostering a diverse and inclusive workplace. Employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.</span></span></p>
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