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Clinical Denials Analyst

Role overview

Qualifications

  • 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

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

Key facts

  • Remote from: Anywhere
  • Full time
  • Senior (5-10 years)
  • English

Hard skills

Other skills

  • Microsoft Office
  • Analytical Skills
  • Critical Thinking
  • Detail Oriented

About the company

Enjoin logo

Enjoin

Digital Health & Health Tech

Enjoin provides a comprehensive solution that integrates care delivery with clinical documentation improvement. With thirty years of direct physician leadership, our team ensures evidenced-based care is accurately reflected through precise documentation and coding for value-based reimbursement. Whether inpatient or ambulatory, the precision of healthcare data defines risk adjusted value-based outcomes through reliable documentation and coding. Led by expert physicians with coding and documentation credentials, our clients achieve a demonstrable improvement in CMI, coding accuracy, quality metrics, risk adjustment, and physician alignment—with an average return on investment over 700%. For more information, contact 844-ENJOIN1 or email info@enjoincdi.com

Company details

IndustryDigital Health & Health Tech
Company size51 - 200

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Job description

About Enjoin

At Enjoin, your work makes a meaningful impact.

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.

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.

Proudly Great Place to Work® Certified for three consecutive years, we're dedicated to creating an environment where our people can do their best work while making a real difference.

Job Summary

The Clinical Denials Analyst (CDA) 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.

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.

What You'll Do

  • 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

Qualifications

Required
  • 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
Preferred
  • RN or MD
  • Healthcare consulting experience
  • Experience working across clinical, coding, CDI, and operational teams

Work Environment & Expectations

  • Fully remote, full-time position (40 hours per week)
  • Monday through Friday during regular business hours
  • Company-issued equipment provided
  • Dedicated secure home workspace required
  • High-speed internet connection required
  • Strict adherence to HIPAA Privacy and Security requirements
  • Ability to work independently while maintaining productivity and quality expectations

Why Enjoin

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.

  • 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

Hiring Process

  • Multiple-choice assessment
  • Phone call with a Talent Acquisition Specialist
  • Video interview with the Hiring Manager (must be on camera)
  • Panel interview with the Denials Team (must be on camera)

Equal Employment Opportunity

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.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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