Inpatient Clinical Documentation Specialist

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.

The Inpatient Clinical Documentation Specialist (CDS) partners with physicians, coding professionals, and clinical teams to improve the accuracy, completeness, and integrity of inpatient medical record documentation. Leveraging strong clinical judgment and CDI expertise, this role reviews concurrent and retrospective patient records, identifies documentation improvement opportunities, and issues compliant provider queries to ensure the patient’s severity of illness, risk of mortality, and overall clinical picture are accurately reflected.

Working as an extension of our clients’ Clinical Documentation Improvement (CDI) programs, the Inpatient CDS helps support accurate coding, appropriate reimbursement, regulatory compliance, and high-quality patient data while delivering exceptional client service.

• Review inpatient medical records to evaluate the accuracy, completeness, and clinical integrity of physician documentation
• Identify documentation improvement opportunities and issue concise, compliant provider queries in accordance with AHIMA and ACDIS best practices
• Collaborate with physicians, coding professionals, and clinical staff to improve documentation quality and coding accuracy
• Analyze clinical documentation, laboratory results, medications, physician orders, diagnostic testing, and other clinical information to validate reportable diagnoses and procedures
• Perform concurrent, continued stay, and retrospective chart reviews while maintaining accurate workflow documentation and meeting client-specific productivity and quality expectations
• Monitor query follow-up, reconciliation, and escalation activities in accordance with client workflows and turnaround expectations
• Apply Official ICD-10-CM/PCS Coding Guidelines, Coding Clinic guidance, and client-specific clinical validity criteria throughout the documentation review process
• Educate providers and clinical staff on documentation best practices that support accurate clinical representation and compliant reimbursement
• Maintain a strong understanding of inpatient coding, DRG assignment, clinical documentation improvement, and healthcare regulations
• Deliver high-quality work while collaborating effectively with internal CDI, coding, quality, and client teams in a fully remote environment

• Active Registered Nurse (RN) license
• Minimum of5 years of acute
  
  Inpatient Clinical documentation Improvement (CDI) experience within a large tertiary or trauma hospital environment
• Experience working withinelectronic health record systems
• Strong knowledge of inpatient CDI practices, physician documentation, ICD-10-CM/PCS coding guidelines, DRG assignment, and compliant query practices
• Excellent clinical judgment, analytical thinking, problem-solving, and critical thinking skills
• Strong…