Enjoin
Overview
Enjoin is seeking a Clinical Denials Analyst (Remote). The CDA conducts reviews of medical records, applies clinical criteria, coding guidelines, and medical necessity standards to determine appeal opportunities. The CDA writes clear, persuasive appeal letters using clinical documentation, payer medical policies, evidence-based literature, and coding guidance, which are reviewed by an Enjoin physician prior to submission. The CDA supports denial analytics, providing insights to Advisory colleagues and physicians to strengthen client CDI workflows, reduce denial credits, and improve client outcomes.
Responsibilities
Manage denials by reviewing medical record documentation, payer criteria, ICD-10-CM/PCS coding guidelines, and patient status criteria to determine appeal opportunities.
Draft succinct, evidence-based appeal letters aligned with clinical documentation, payer policies, and coding guidance, submitting to the physician reviewer prior to client delivery.
Track and analyze denial data; share trends and insights with Advisory colleagues and physicians to support CDI best practices and identify opportunities for internal process improvement.
Provide recommendations to management to reduce denial credits and enhance DRG Assurance outcomes.
Maintain strong organizational practices to manage multiple appeals, deadlines, and client deliverables effectively.
Qualifications
Current CCS, RHIT, RHIA, CDIP, and/or CCDS credential required
Clinical practice background required; minimum 5 years of bedside clinical experience preferred.
Minimum 3 years of CDI or coding experience in an acute inpatient hospital setting required.
Minimum 2 years of direct clinical denials management experience with proven success in writing and overturning denials required.
Strong knowledge of ICD-10-CM/PCS, AHA Coding Clinic, and CMS regulatory guidance required.
Demonstrated success in analyzing denials, identifying trends, and presenting complex clinical concepts clearly and persuasively required.
Proficiency in Microsoft Word and Excel; knowledge of EMR systems such as Epic or Cerner required.
Preferred Skills
Minimum 1 year of case management or utilization review experience.
Experience with payer interaction and knowledge of payer-specific denial trends.
Familiarity with reimbursement methodologies (MS-DRG, APR-DRG, HCC).
Understanding of payer audits (RAC/MAC) and compliance risk mitigation strategies.
Strong critical thinking skills with the ability to differentiate payer interpretation from regulatory standards.
Why Enjoin?
Great Place to Work Certified: This certification recognizes employers who create an outstanding employee experience
Be a valuable member of a dynamic team of physicians, CDI, and coding professionals
Career stability and professional growth opportunities
Full benefits (medical, vision, dental)
401(k) contribution of 3%
Excellent PTO package plus 8 paid holidays
Work 100% remote
Flexible schedule
Laptop and other necessary equipment provided
Complimentary annual CEUs
Access to advanced educational coding tools/resources
Employee Wellness and Discount programs
Referral bonus program for coding and CDI experts
Work Environment
This is a full-time remote position. General hours are Monday through Friday during regular business hours.
Must have a reliable internet connection, phone, and a dedicated, secure workspace to ensure adherence to HIPAA Privacy and Security policies when viewing PHI.
Enjoin provides a laptop and other necessary resources to perform duties.
Interview Process
Fill out the quick application today!
Multiple Choice Denials Assessment (20 questions)
Video meeting with Denials Manager (1 hour)
Enjoin is an equal opportunity employer and values diversity in its workforce. We encourage applications from all qualified candidates.
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Responsibilities
Manage denials by reviewing medical record documentation, payer criteria, ICD-10-CM/PCS coding guidelines, and patient status criteria to determine appeal opportunities.
Draft succinct, evidence-based appeal letters aligned with clinical documentation, payer policies, and coding guidance, submitting to the physician reviewer prior to client delivery.
Track and analyze denial data; share trends and insights with Advisory colleagues and physicians to support CDI best practices and identify opportunities for internal process improvement.
Provide recommendations to management to reduce denial credits and enhance DRG Assurance outcomes.
Maintain strong organizational practices to manage multiple appeals, deadlines, and client deliverables effectively.
Qualifications
Current CCS, RHIT, RHIA, CDIP, and/or CCDS credential required
Clinical practice background required; minimum 5 years of bedside clinical experience preferred.
Minimum 3 years of CDI or coding experience in an acute inpatient hospital setting required.
Minimum 2 years of direct clinical denials management experience with proven success in writing and overturning denials required.
Strong knowledge of ICD-10-CM/PCS, AHA Coding Clinic, and CMS regulatory guidance required.
Demonstrated success in analyzing denials, identifying trends, and presenting complex clinical concepts clearly and persuasively required.
Proficiency in Microsoft Word and Excel; knowledge of EMR systems such as Epic or Cerner required.
Preferred Skills
Minimum 1 year of case management or utilization review experience.
Experience with payer interaction and knowledge of payer-specific denial trends.
Familiarity with reimbursement methodologies (MS-DRG, APR-DRG, HCC).
Understanding of payer audits (RAC/MAC) and compliance risk mitigation strategies.
Strong critical thinking skills with the ability to differentiate payer interpretation from regulatory standards.
Why Enjoin?
Great Place to Work Certified: This certification recognizes employers who create an outstanding employee experience
Be a valuable member of a dynamic team of physicians, CDI, and coding professionals
Career stability and professional growth opportunities
Full benefits (medical, vision, dental)
401(k) contribution of 3%
Excellent PTO package plus 8 paid holidays
Work 100% remote
Flexible schedule
Laptop and other necessary equipment provided
Complimentary annual CEUs
Access to advanced educational coding tools/resources
Employee Wellness and Discount programs
Referral bonus program for coding and CDI experts
Work Environment
This is a full-time remote position. General hours are Monday through Friday during regular business hours.
Must have a reliable internet connection, phone, and a dedicated, secure workspace to ensure adherence to HIPAA Privacy and Security policies when viewing PHI.
Enjoin provides a laptop and other necessary resources to perform duties.
Interview Process
Fill out the quick application today!
Multiple Choice Denials Assessment (20 questions)
Video meeting with Denials Manager (1 hour)
Enjoin is an equal opportunity employer and values diversity in its workforce. We encourage applications from all qualified candidates.
#J-18808-Ljbffr