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Vice President, Revenue Integrity - DRG & DRGV (REMOTE)

2 weeks, 4 days ago
United States
Full-time
Executive
Operations Manager
Operations
HIPAA
Apply Now
EnableComp

EnableComp

EnableComp specializes in complex claims and specialty revenue cycle management solutions for healthcare providers, focusing on optimizing reimbursements for various claims types, including VA, Workers' Compensation, and Motor Vehicle Accidents, throug...

Insurance
251-1K
Founded 2000
View All Jobs 6

Description

  • Lead Revenue Integrity products and service teams across DRG & DRGV, medical necessity denials, and ED downgrades.
  • Define departmental goals, financial targets, and key performance indicators aligned to company objectives.
  • Set strategic direction for Revenue Recovery and drive continuous improvement with senior leadership.
  • Oversee quality and productivity metrics, benchmarks, and reporting for Revenue Recovery functions.
  • Create, communicate, and train process changes and operational best practices.
  • Ensure processes and inventory support monthly, quarterly, and annual revenue expectations.
  • Hire, train, coach, and evaluate staff, including workload distribution and performance reviews.
  • Coordinate cross-functional resources for client action plans, projects, and strategic initiatives.
  • Monitor performance metrics, explain variances, and provide corrective action plans to stakeholders and management.
  • Maintain regulatory, compliance, coding, and reimbursement knowledge, including HIPAA and coding guidelines.

Requirements

  • Bachelor’s degree in health information management, Nursing, Healthcare Administration, Business, or a related field required; Master’s degree preferred.
  • Active CCS, RHIT, or RHIA certification strongly preferred.
  • 7-10 years of progressive leadership experience in healthcare reimbursement.
  • 5+ years of experience in clinical denials or inpatient claims environments.
  • Experience working in a client-facing or client support role with internal teams.
  • Strong understanding of inpatient coding, DRG reimbursement methodology, medical record auditing, and payer guidelines.
  • Experience navigating hospital revenue cycle environments and working with large-scale data/reporting tools.
  • Demonstrated ability to operate effectively at both strategic and operational levels.
  • Timely and regular attendance required.
  • Experience in a production environment and ability to meet deadlines.
  • Strong written and oral communication skills and excellent interpersonal skills.
  • Ability to manage multiple priorities, multiple projects, and several teams simultaneously.
  • Ability to provide examples of goal measurement, managing individual goals, and handling obstacles with action plans.
  • Healthcare experience and familiarity with payer or provider data sets.
  • Equivalent combination of education and experience will be considered.

Benefits

  • Remote work arrangement.
  • Full-time executive position.
  • Opportunity to work for a multi-year Top Workplaces recipient and a fast-growing industry leader.
  • Commitment to employee professional growth and development.
  • Family-oriented and flexible work culture.
  • Supportive environment that values work-life balance.
  • Equal opportunity employer commitment to an inclusive workplace.

Interested in this position?

Apply directly on the company website

Apply Now

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