Enjoin is an industry leader commited to providing comprehensive clinical documentation improvement solutions that are physician-led and quality-driven. We are seeking an experienced Clinical Denials Analyst to join our team. If you possess in-depth knowledge of the denials and appeals process, we invite you to apply.
As a Clinical Denials Analyst, you will play an important role, including the following responsibilites:
- Perform advanced level work related to clinical denials
management.
- Manage denials by conducting a comprehensive review
of clinical documentation in the medical record, relevant clinical criteria for diagnosis denied (if applicable), appropriate coding guidelines, and/or patient status criteria for medical necessity denials to complete the denial review before determining appeal opportunities.
- Write succinct appeal letters based on the clinical documentation in the medical record, the medical policies of the client’s payor, evidence-based medicine literature, and any applicable coding guidelines before submitting the appeal letter to the Enjoin physician for additional review.
- Handle denial analytics for sharing trends with Advisory colleagues
and Enjoin physicians, to drive client best practice CDI workflows with clients and any internal opportunities to reduce denial credits.
- Provide input and recommendations to management team for process improvement needed to reduce any denial credits for DRG Assurance clients.
You will be the ideal candidate for this role if you have:
- Current CCS, CDIP or CCDS (AHIMA) credential (required). Graduate of an accredited Health Information Technology or Administration program (preferred).
- Minimum of 5 years of acute inpatient hospital coding, auditing, and/or CDI experience in a large tertiary hospital (required). Consulting experience (preferred).
- Strong knowledge of ICD-10CM/PCS (required).
- Strong experience with managing the denials and appeals process, including writing appeal letters (required).
Why Enjoin?
- Be a valuable member of a dynamic team of physicians, CDI and coding professionals
- Career stability and professional growth opportunities
- Competative compensation package
- Full benefits (medical, vision, dental)
- 401(k) contribution of 3%
- Excellent PTO package plus 7 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
Schedule: This is a remote, full-time, 40 hour per week position. General hours of work are Monday through Friday during regular business hours.
Enjoin is an equal opportunity employer and values diversity in its workforce. We encourage applications from all qualified candidates.
For more 35 years, Enjoin has provided health systems with clinical documentation integrity (CDI) education, infrastructure and process development. A pioneer of CDI programs, Enjoin continues to be an industry leader and innovator. Led by nationally renowned physicians with a strong academic background in scientific-based medicine and years of clinical practice coupled with certified coding and clinical documentation credentials, our unique approach addresses today’s quality-driven initiatives uniting documentation and coding across the healthcare continuum.
Job Type: Full-time
Pay: $48.00 - $52.00 per hour
Expected hours: 40 per week
Benefits:
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Work from home
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work setting:
- Hospital
- Remote
- Teaching hospital
Experience:
- Denials: 1 year (Required)
- ICD-10CM/PCS coding and/or auditing: 5 years (Preferred)
- Appeal Letter Writing: 1 year (Required)
Work Location: Remote