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