Clinical Coding Analyst (Clinical Validation & DRG Review)

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 Coding Analyst (CCA) performs pre-bill inpatient medical record reviews to identify coding opportunities, potential compliance risks, and documentation improvements that support accurate MS-DRG assignment and appropriate reimbursement. Using advanced knowledge of ICD-10-CM/PCS, AHA Coding Clinic guidance, Medicare regulations, and clinical validation, this position develops clear, evidence-based recommendations for clients.

Working closely with Enjoin physicians and client coding and CDI teams, the Clinical Coding Analyst reviews complex cases, communicates findings, responds to rebuttals, and supports denial and quality-related initiatives. This is a fully remote position requiring strong analytical ability, sound judgment, accuracy, and the ability to consistently meet 24-hour turnaround expectations.

What You'll Do

• Perform daily pre-bill reviews of inpatient medical records for assigned clients
• Identify revenue opportunities, coding compliance risks, and documentation concerns using ICD-10-CM/PCS guidelines, AHA Coding Clinic guidance, Medicare regulations, and clinical judgment
• Evaluate clinical indicators and documentation supporting diagnoses, procedures, and MS-DRG assignment
• Conduct verbal case reviews with Enjoin physicians for records involving potential MS-DRG changes or provider query opportunities
• Develop and submit clear, evidence-based client recommendations, including increased reimbursement, decreased reimbursement, and informational notifications
• Complete assigned reviews and deliver client recommendations within the required 24-hour turnaround time
• Respond to client questions and rebuttals in accordance with internal protocols and established service expectations
• Upload daily worklists and accurately record all required recommendation data in Enjoin’s MS-DRG database
• Support review and appeal activities involving Medicare and third-party payer denials processed through the MS-DRG Assurance program
• Review inclusion and exclusion criteria related to 30-day readmission and mortality quality measures for designated Medicare populations
• Maintain active access to all assigned client systems and ensure credentials remain current
• Utilize Enjoin tools and coding resources, including TruCode, the Enjoin I10 Wiki, and CDocT
• Maintain current knowledge of ICD-10-CM/PCS updates, AHA Coding Clinic guidance, Medicare regulations, and relevant industry developments
• Adhere to all company policies, procedures, confidentiality requirements, and compliance standards

Qualifications

Required

• Active CCS, RHIT, RHIA, CDIP, or CCDS credential
• Minimum of four years of acute inpatient hospital coding, coding audit, and/or CDI experience within a large tertiary hospital
• Extensive knowledge of ICD-10-CM/PCS, Official Coding Guidelines, AHA Coding Clinic guidance, and MS-DRG methodology
• Experience working with electronic health record systems such as Epic, Cerner, or Meditech
• Previous experience working in a remote environment
• Strong clinical and coding analytical skills with the ability to identify opportunities, compliance risks, and unsupported documentation
• Excellent written and verbal communication skills
• Ability to clearly explain and defend coding recommendations
• Demonstrated initiative, resourcefulness, accuracy, and sound professional judgment
• Ability to work independently, manage competing priorities, and consistently meet required turnaround times
• Excellent planning and organizational skills
• Strong collaboration, teamwork, and adaptability
• Proficiency with Microsoft Word and Excel
• High-speed internet and a dedicated, secure workspace that supports compliance with HIPAA privacy and security requirements

Preferred

• AHIMA-approved ICD-10-CM/PCS Trainer designation
• Experience supporting Clinical Documentation Integrity programs
• Experience reviewing coding or clinical denials
• Experience with APR, 30-day readmission, mortality, or other healthcare quality measures

Work Environment & Expectations

• Fully remote, with company-issued computer equipment provided
• Monday - Friday during regular business hours
• Must maintain a secure home workspace and reliable high-speed internet connection
• Must maintain strict HIPAA compliance and confidentiality
• Demonstrate accountability, professionalism, and proactive communication

Compensation

• $100,000 - $110,000 annually plus quarterly performance-based bonus opportunities

Why Enjoin

We offer a comprehensive total rewards package designed to support our team members professionally and personally, including:

• 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, leadership training, and internal growth opportunities
• Recognition programs and performance-based rewards
• Employee wellness resources and discount programs
• White glove onboarding designed to set you up for success
• A collaborative, people-first culture recognized as a Great Place to Work® for three consecutive years

Hiring Process

• Multiple-choice assessment
• Phone call with a Talent Acquisition Specialist
• Video interview with the Hiring Manager (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 characteristic protected by applicable federal, state, or local law.