Director, DRG Validation & Revenue Integrity

Revecore; Kentucky; Remote; USD 190.000 - 260.000; Vollzeit

Zusammenfassung

Revecore is seeking a Director, Diagnosis-Related Group Validation (DRGV) to lead the development and launch of our DRGV service offering, expanding the Billing and Coding Optimization (BCO) capabilities in response to client demand. This role blends deep DRGV expertise with service-line strategy and scalable workflows, staffing, and performance standards.

The candidate will partner with Product, Data, AI, Development, and Operations to translate DRGV requirements into technology-enabled

Qualifikationen

• Deep DRGV expertise with hands-on coding background.
• Expert knowledge of MS-DRG classification and reimbursement.
• Strong understanding of revenue cycle, charge capture and CDI.

Aufgaben

• Define operating model, workflows, staffing, productivity metrics and quality standards for the DRGV service.
• Provide subject matter expertise across DRGV including coding, MS-DRG, revenue integrity and claims.
• Partner with Product, Data, AI, Development and Operations to translate DRGV requirements into scalable processes and tech solutions.
• Identify opportunities to use AI and automation to improve account selection, prioritization, processing and delivery.
• Serve as liaison between DRGV SMEs and Product/Engineering for code-table requirements.
• Establish performance expectations and monitor progress against goals.
• Advise on pricing, marketing, positioning and sales enablement for DRGV offering.
• Support client-facing sales discussions with DRGV expertise.
• Collaborate with BCO team to deliver services to clients.
• Drive execution across a matrixed org to adopt a new solution.

Kenntnisse

DRGV expertise

MS-DRG knowledge

revenue integrity

coding/ CDI familiarity

AI & automation awareness

cross-functional leadership

client-facing communication

pricing & go-to-market input

stakeholder collaboration

Jobbeschreibung

Revecore is seeking a Director, Diagnosis-Related Group Validation (DRGV) to lead the development and launch of our DRGV service offering, expanding the Billing and Coding Optimization (BCO) capabilities in response to client demand. This role blends deep DRGV expertise with service-line strategy and scalable workflows, staffing, and performance standards.

The candidate will partner with Product, Data, AI, Development, and Operations to translate DRGV requirements into technology-enabled