• Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention. • Partner with provider clients to design and implement best practices for denial prevention and appeal workflows. • Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments. • Develop and refine clinical appeal strategies and templates to improve success rates. • Analyze denial trends across multiple clients and provide actionable insights to reduce recurring clinical denials. • Collaborate with coding, Clinical Documentation Integrity (CDI), and client operations teams to ensure consistency in methodologies and documentation practices. • Support proposal and implementation teams by contributing clinical expertise to solution design and client onboarding. • Maintain deep familiarity with Centers for Medicare & Medicaid Services (CMS) regulations, payer guidelines, and medical necessity criteria such as InterQual and MCG Health (formerly Milliman Care Guidelines). • Represent the organization as a clinical expert in client meetings, audits, and appeal escalations. • Represent EnableComp as an industry expert at national and regional conferences, networking opportunities, community outreach events, and client meetings. • Serve as a spokesperson for the company through webinars, speaking engagements, panel discussions, and authored articles. • Develop white papers, policy briefs, industry reports, and thought leadership content to elevate the organization's presence in the RCM and policy landscape. • Engage with payers and provider networks to advocate for streamlined administrative processes, and enhanced reimbursement methodologies. • Lead client education sessions and internal training programs on Medicare Severity Diagnosis Related Group (MS-DRG) and All Patient Refined Diagnosis Related Group (APR-DRG) validation, clinical documentation integrity, and payer policy application. • Partner with the sales and client success teams to educate prospective and existing clients on EnableComp’s services, value proposition, and regulatory insights. • Provide in-depth RCM expertise in responding to RFPs, proposals, and client inquiries. • Conduct training sessions and presentations on complex claims and industry trends for internal teams and clients.