Senior Process Executive - Clinical Specialist

Enovis Corporation; Hyderabad; Presencial; INR 900 000 - 1 300 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Life insurance

Transportation allowance

Nightshift allowance

Leaves and holidays

Resumo da oferta

Enovis Corporation in Hyderabad, India is seeking a Senior Process Executive - Clinical Specialist to bridge clinical documentation with revenue cycle operations. You will ensure accurate chart review, support coding, validate charges, and help optimize reimbursement while maintaining payer compliance.

You will mentor junior associates and contribute to process improvements in a fast-paced, patient-focused environment within orthopedics and related sectors.

Qualificações

• US healthcare revenue cycle management experience.
• Clinical documentation review and CDI initiatives.
• Experience with payer policies and CMS guidelines.
• Ability to educate providers on documentation best practices.

Responsabilidades

• Clinical Documentation Review to ensure completeness and compliance.
• Revenue Cycle Support to analyze claims and reduce denials.
• Coding & Compliance Collaboration with coders for accurate ICD-10-CM/CPT/HCPCS coding.
• Denial Management to investigate denials and drive corrective actions.

Conhecimentos

US Healthcare RCM

Clinical Documentation Review

Denial Management

Payer policies

Communication skills

Formação académica

Bachelor's Degree in Nursing

RN License

Bachelors in Life Sciences

Ferramentas

EMR/EHR systems

ICD-10-CM CPT/HCPCS

Medicare/Medicaid payer systems

Descrição da oferta de emprego

Who We Are

ABOUT ENOVIS Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit www.enovis.com.

What You’ll Do

At Enovis we pay attention to the details. We embrace collaboration with our partners and patients and take pride in the pursuit of scientific excellence — with the goal of transforming medical technology as we know it. Because that’s how we change the lives of patients for the better. And that’s how we create better together. Why work at Enovis? See for yourself.

As a key member of the Revenue Cycle Management team, you will play an integral part in helping Enovis drive the medical technology industry forward by transforming patient care and improving patient outcomes.

Job Title: Senior Process Executive - Clinical Specialist

Location: Hyderabad, India

Business Unit: Revenue Cycle Management

Role Summary: The Senior Process Executive - Clinical Specialist serves as a bridge between clinical documentation and revenue cycle operations, ensuring accurate medical record review, coding support, charge capture validation, payer compliance, and denial prevention. This role collaborates with healthcare providers, coders, billing teams, and payers to optimize reimbursement while maintaining compliance with US healthcare regulations and payer guidelines. The position requires strong communication skills, analytical abilities, and knowledge of revenue cycle management (RCM) to resolve claim issues, reduce outstanding AR, and improve cash flow. Additionally, the Senior Process Executive will mentor junior associates and contribute to process improvements. This is an incredible opportunity to work in a fast-moving, patient-focused setting amongst extraordinarily talented professionals dedicated to making life-changing innovations possible in orthopedics and beyond with brands such as DonJoy, Aircast, ProCare and Exos.

Key Responsibilities

Clinical Documentation Review

• Review medical records to ensure completeness, accuracy, and compliance with payer requirements.
• Identify documentation gaps that may impact coding accuracy and reimbursement.
• Support Clinical Documentation Improvement (CDI) initiatives.
• Educate providers on documentation best practices.

Revenue Cycle Support

• Analyze claims for documentation-related denials and underpayments.
• Assist in resolving clinical denials, medical necessity denials, and authorization-related denials.
• Review appeals and prepare supporting clinical documentation.
• Ensure accurate charge capture and reimbursement optimization.

Coding & Compliance Collaboration

• Work closely with medical coders to ensure accurate ICD-10-CM, CPT, and HCPCS coding.
• Validate medical necessity requirements based on payer policies.
• Monitor compliance with CMS, Medicare, Medicaid, and commercial payer regulations.
• Support internal and external audits.

Denial Management

• Investigate denied claims and identify root causes.
• Prepare clinical appeal letters and supporting documentation.
• Track denial trends and recommend corrective actions.
• Collaborate with AR and billing teams to reduce denial rates.

Required Skills

• Education Bachelor's Degree in Nursing, Life Sciences, Healthcare Administration, Pharmacy, or related healthcare field. RN (Registered Nurse), BPT, B.Pharm, M.Pharm, or equivalent clinical qualification preferred.
• Experience 2–5+ years of experience in US Healthcare RCM, Clinical Documentation Review, CDI, Utilization Management, or Denial Management.
• Experience working with Medicare, Medicaid, and Commercial Insurance payers.
• Knowledge of medical necessity guidelines and payer policies.
• Technical Knowledge Understanding of: ICD-10-CM CPT/HCPCS coding fundamentals Medical terminology Anatomy and physiology CMS guidelines Revenue Cycle Management processes EMR/EHR systems

Preferred Certifications

• Certified Clinical Documentation Specialist (CCDS) Certified Documentation Improvement Practitioner (CDIP) CPC, CCS, or CRC certification RN License (if applicable)

Benefits

• Medical, Life, and Accidental Insurance
• Leaves and Holidays
• Transportation Allowance/ Pick and Drop Facility
• Nightshift Allowances and Other Benefits

ABOUT ENOVIS

Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services and integrated technologies fuels active lifestyles in orthopedics and beyond.

Visit www.enovis.com to learn more.

EQUAL EMPLOYMENT OPPORTUNITY

Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria and without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees’ beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis.

EQUAL EMPLOYMENT OPPORTUNITY

Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees’ beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis.