Subject Matter Expert - Clinical Specialist

Posted 2 Days Ago
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Hyderabad, Telangana, IND
In-Office
Senior level
Healthtech
The Role
Serve as a bridge between clinical documentation and revenue cycle operations: review medical records, support CDI, validate coding and charge capture, resolve denials, prepare appeals, mentor junior staff, and ensure payer and CMS compliance to optimize reimbursement and reduce AR.
Summary Generated by Built In
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 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

Candidate should have an 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)

 
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.

“Creating better together”. It’s the Enovis purpose, and it’s what drives us and empowers us every day on a global scale. We know that the power to create better – for our customers, our team members, and our shareholders – begins with having the best team, pursuing common goals, operating at the highest levels, and delivering extraordinary outcomes.

What does creating better together mean to us at Enovis? Discover the “why” behind our purpose, values and behaviors:

Our Enovis Purpose, Values and Behaviors on Vimeo

We offer a comprehensive benefits package which includes:

  • 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.

Skills Required

  • Bachelor's degree in Nursing, Life Sciences, Healthcare Administration, Pharmacy, or related healthcare field
  • Registered Nurse (RN), BPT, B.Pharm, M.Pharm, or equivalent clinical qualification
  • 2-5+ years experience in US Healthcare RCM, Clinical Documentation Review, CDI, Utilization Management, or Denial Management
  • Experience working with Medicare, Medicaid, and Commercial Insurance payers and medical necessity guidelines
  • Knowledge of ICD-10-CM, CPT, and HCPCS coding fundamentals
  • Understanding of medical terminology, anatomy and physiology
  • Familiarity with CMS guidelines and payer policies; support internal/external audits
  • Familiarity with Revenue Cycle Management processes and EMR/EHR systems
  • Certified Clinical Documentation Specialist (CCDS), CDIP, CPC, CCS, or CRC certifications
  • RN license (if applicable)
  • Strong communication, analytical skills, and mentoring/leadership experience

Enovis Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Enovis and has not been reviewed or approved by Enovis.

  • Healthcare Strength Healthcare coverage is positioned as comprehensive, with multiple medical, dental, and vision plan options plus HSA/FSA accounts. Income protection offerings are also described as robust, including life, AD&D, and short- and long-term disability coverage.
  • Retirement Support Retirement benefits include access to a 401(k) plan with an employer match described as competitive. This adds to the overall total-rewards value even where cash compensation sentiment is uneven.
  • Leave & Time Off Breadth Time-off provisions are described as ample, including vacation, sick leave, and holidays. Paid parental and family leave is also offered, with a stated maximum of six weeks for eligible employees after birth or adoption.

Enovis Insights

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The Company
HQ: Wilmington, DE
1,217 Employees
Year Founded: 2022

What We Do

We are a medical technology company focused on developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, extraordinary talent and innovation, we ‘create better together’ by partnering with healthcare professionals. Our extensive range of products, services and integrated technologies fuel active lifestyles.

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