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

Vice President, Revenue Integrity - DRG & DRGV (REMOTE) EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry‑leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human‑in‑the‑loop integration, EnableComp delivers solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out‑of‑State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data‑rich performance management. Position Summary Lead Revenue Recovery products under the Denials umbrella, including Diagnosis‑Related Group (DRG & DRGV), Medical Necessity Denials, and Emergency Downgrades. Provide leadership and supervision to achieve quantifiable results, set departmental goals, drive operational performance, client satisfaction, and continuous improvement. Report to senior management on obstacles, challenges, and opportunities impacting revenue projections. Job Responsibilities Act as a subject matter expert in Revenue Integrity products. Define departmental goals, financial targets, and key performance indicators. Assist in setting strategic direction of Revenue Recovery and identify continuous improvement areas. Oversee development of quality and productivity metrics and benchmarks. Drive process changes, training, and operational best practices. Ensure processes and inventory meet revenue expectations. Hire, train, and manage staff, including performance reviews and workload distribution. Coordinate resources across the organization for action plans. Collaborate with senior leaders on planning, resource allocation, and partnerships. Set daily priorities to maximize impact. Measure and report key performance metrics; provide corrective action plans. Explain variances to management regarding DRG reviews, billing activity, and revenue metrics. Research and analyze processes for improvement opportunities and SOP enhancements. Maintain high‑level client relationships and ensure satisfaction. Develop training materials and support onboarding and education. Build a high‑performing, scalable organizational structure through coaching and accountability. Maintain knowledge of regulatory and compliance requirements and ensure staff adherence. Maintain strong knowledge of DRG coding, clinical documentation, and reimbursement methodologies. Perform other duties as required. Requirements & Qualifications Bachelor’s degree in health information management, Nursing, Healthcare Administration, Business, or related field (Master’s preferred). Active Certified Coding Specialist (CCS), RHIT, or RHIA strongly preferred. 7‑10 years of progressive leadership experience in healthcare reimbursement, with 5+years in clinical denials or inpatient claims environments. Experience working with internal teams while serving in a client‑facing or client support role. 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 strategically and operationally. Timely and regular attendance. Equivalent combination of education and experience will be considered. Eligible for reasonable accommodations, as required. Special Considerations & Prerequisites Adherence to EnableComp’s Core Values, Vision, and Mission. Travel 0‑10% in a general office environment. Strong written and oral communication skills. Experience meeting production deadlines and measuring goals. Excellent people skills for interface with internal stakeholders. Proven success in obtaining quantifiable results and setting priorities for direct reports. Organized and able to handle multiple simultaneous projects. Healthcare experience and familiarity with payer or provider data sets. Ability to set and manage multiple priorities across teams. Experience communicating obstacles and developing action plans for management. EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment. #J-18808-Ljbffr