Vice President, Revenue Integrity – DRG, DRGV

EnableComp

. Lead and supervise Revenue Recovery products under the Denials umbrella, including DRG/DRGV, Medical Necessity Denials, and ED Downgrades.

Posted 10/27/2026full-timeRemote • Tennessee • United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Revenue Recovery and Denials management, with a strong focus on DRG coding, clinical documentation, and compliance with regulatory requirements. Proven ability to lead teams, set strategic goals, and drive continuous improvement in healthcare reimbursement processes.

Highest-signal resume keywords

Revenue Recovery LeadershipDRG Coding ExpertiseCertified Coding Specialist (CCS)Healthcare Reimbursement ExperiencePerformance Metrics Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Inpatient CodingDRG Reimbursement MethodologyMedical Record AuditingPayer GuidelinesOperational Process AnalysisQuality ImprovementData Reporting ToolsFinancial Target SettingPerformance MonitoringStrategic Planning

Soft Skills

Strong Written CommunicationExcellent People SkillsOrganizational SkillsAbility to Handle Multiple ProjectsClient-Facing Experience

Certifications & Qualifications

Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)

Industry Keywords

Healthcare AdministrationRevenue Cycle ManagementDenials ManagementCompliance RequirementsHIPAAClinical DenialsInpatient ClaimsHealthcare ExperiencePayer Data SetsPerformance Metrics

About the role

Key responsibilities & impact

Lead and supervise Revenue Recovery products under the Denials umbrella, including DRG/DRGV, Medical Necessity Denials, and ED Downgrades.
Serve as a subject matter expert for Revenue Integrity products.
Define departmental goals, financial targets, and key performance indicators aligned with company objectives.
Help set the strategic direction of Revenue Recovery and identify continuous improvement opportunities.
Oversee quality and productivity metrics and benchmarks.
Create, communicate, and train teams on process changes and operational best practices.
Ensure processes and inventory support monthly, quarterly, and annual revenue expectations.
Hire, train, supervise, and evaluate staff, including goal planning, performance reviews, workload distribution, and performance monitoring.
Coordinate organizational resources for client and project action plans.
Collaborate with senior leaders on corporate planning, resource allocation, and strategic partnerships.
Set daily priorities and ensure impactful work is appropriately staffed.
Monitor performance metrics and provide stakeholder reporting with corrective action plans.
Explain variances to management involving DRG reviews, billing activity, and revenue metrics.
Analyze operational processes and systems for improvement opportunities and SOP enhancements.
Manage high-level client relationships, performance updates, collaboration, and escalated concerns.
Oversee training materials, onboarding, ongoing education, and quality improvement.
Develop a high-performing, scalable organizational structure through leadership, coaching, and accountability.
Maintain knowledge of HIPAA, coding guidelines, regulatory and compliance requirements, and ensure staff adherence.
Maintain expertise in DRG coding, clinical documentation, and reimbursement methodologies.
Perform other duties as required.

Requirements

What you’ll need

Bachelor’s degree in health information management, Nursing, Healthcare Administration, Business, or related field required; Master’s degree preferred.
Active Certified Coding Specialist (CCS), RHIT, or RHIA strongly preferred.
7-10 years’ progressive leadership experience in healthcare reimbursement, including 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.
Ability to operate effectively at strategic and operational levels.
Timely and regular attendance.
Equivalent combination of education and experience will be considered.
Ability to perform essential duties satisfactorily; reasonable accommodations may be made for qualified individuals with disabilities.
Adherence to EnableComp’s Core Values, Vision, and Mission.
Travel 0–10%; general office environment.
Strong written and oral communication skills.
Experience working in a production environment and meeting deadlines.
Excellent people skills for interfacing with multiple internal stakeholders.
Proven success obtaining quantifiable results and setting priorities for direct reports.
Organized and able to handle multiple projects simultaneously.
Healthcare experience and familiarity with payer or provider data sets.
Ability to set and manage multiple priorities among several teams.
Experience communicating obstacles and challenges and developing action plans for management.

Benefits

Comp & perks

Professional growth and development opportunities
Tools, resources, and support for career development
Flexible and family-oriented work environment
Work-life balance support
Remote work option