Remote Director, DRG Validation & Revenue Integrity

Revecore; Oklahoma; Remote; USD 180,000 - 240,000; Full time

Job summary

Revecore is seeking a Director of Diagnosis-Related Group Validation (DRGV) to lead the development and launch of our DRGV service offering, expanding Billing and Coding Optimization capabilities. You will translate industry knowledge into a scalable operating model, technology-enabled workflows, staffing and pricing strategies.

The role partners with Product, Data, AI, Development, and Operations to deliver DRGV solutions, drive adoption, and ensure performance against financial goals across a

Qualifications

• Deep DRGV expertise grounded in hands-on coding experience.
• Strong MS-DRG classification and reimbursement knowledge.
• Understanding of revenue cycle and Clinical Documentation Integrity (CDI).
• Experience interpreting payer contracts and claim adjudication processes.
• Experience designing, leading, or contributing to DRGV programs with workflows and staffing models.
• Experience maintaining complex coding or reimbursement code tables.

Responsibilities

• Define operating model, workflows, staffing requirements, productivity metrics, quality standards, and benchmarks to scale the DRGV service line.
• Provide SME across DRGV including coding, MS-DRG, revenue integrity, and claims."
• Partner with Product, Data, AI, Development, and Operations teams to translate DRGV requirements into scalable processes and technology solutions.
• Identify opportunities to use AI and automation to improve account selection, prioritization, processing, productivity, and service delivery.
• Serve as liaison between DRGV SMEs and Product/Engineering, including supporting code-table requirements.
• Establish performance expectations and monitor progress against implementation, operational, and financial goals.
• Advise on pricing models, marketing strategy, positioning, and sales enablement for the DRGV offering.

Skills

DRGV expertise

MS-DRG knowledge

Revenue integrity

Coding & CDI

Payer contracts

Cross-functional leadership

AI & automation in DRGV

Job description

Revecore is seeking a Director of Diagnosis-Related Group Validation (DRGV) to lead the development and launch of our DRGV service offering, expanding Billing and Coding Optimization capabilities. You will translate industry knowledge into a scalable operating model, technology-enabled workflows, staffing and pricing strategies.

The role partners with Product, Data, AI, Development, and Operations to deliver DRGV solutions, drive adoption, and ensure performance against financial goals across a