Director, DRG Validation & Revenue Integrity - Remote

Revecore; Missouri; Remoto; USD 190.000 - 230.000; Tempo pieno

Descrizione del lavoro

Revecore is seeking a Director of Diagnosis-Related Group Validation (DRGV) to lead the development and launch of DRGV services within our Billing and Coding Optimization portfolio. You will define operating models, scalable processes, and staffing while partnering with Product, Data, AI, and Operations to deliver technology-enabled solutions.

The role drives pricing strategy, sales enablement, and client-facing engagements, leveraging deep DRGV expertise and healthcare reimbursement knowledge

Competenze

• Deep expertise in Diagnosis-Related Group Validation (DRGV) with hands-on coding experience.
• Strong MS-DRG classification and reimbursement knowledge.
• Solid understanding of revenue cycle, charge capture, coding, and CDI.

Mansioni

• Define the operating model, workflows, staffing and productivity metrics to scale the service line.
• Provide DRGV subject-matter expertise across coding, MS-DRG, revenue integrity, and claims.
• Collaborate with Product, Data, AI, Development, and Operations to build scalable processes and tech.
• Identify AI/automation opportunities to improve account selection and delivery.
• Serve as liaison between DRGV experts and Product/Engineering for coding table requirements.
• Set performance metrics and monitor progress against goals.
• Advise on pricing, marketing, and sales enablement for the DRGV offering.
• Support client discussions with DRGV expertise and solution development.
• Coordinate with BCO team to deliver client services.

Conoscenze

DRGV expertise

MS-DRG knowledge

Revenue integrity

Charge capture

Payer contracts

AI/Automation

Cross-functional leadership

Client-facing comms

Descrizione del lavoro

Revecore is seeking a Director of Diagnosis-Related Group Validation (DRGV) to lead the development and launch of DRGV services within our Billing and Coding Optimization portfolio. You will define operating models, scalable processes, and staffing while partnering with Product, Data, AI, and Operations to deliver technology-enabled solutions.

The role drives pricing strategy, sales enablement, and client-facing engagements, leveraging deep DRGV expertise and healthcare reimbursement knowledge