Vice President, Revenue Recovery (REMOTE)

OpenKrill; United States; Remote; USD 200,000 - 280,000; Full time

Job summary

EnableComp is seeking a VP, Revenue Recovery to lead the Revenue Recovery products including DRG/DRGV and Medical Necessity Denials. You will drive strategy, supervise cross-functional teams, and ensure regulatory compliance while delivering strong client outcomes.

The role requires leadership across departments, development of KPIs, and ongoing process improvement to optimize revenue recovery for hospitals nationwide.

Qualifications

• Bachelor’s degree in health information management, Nursing, Healthcare Administration, Business, or related field.
• Active CCS, RHIT, or RHIA strongly preferred.
• 7–10 years’ leadership in healthcare reimbursement, 5+ years in clinical denials/inpatient claims.
• Experience with large-scale data/reporting tools and payer guidelines.
• Strong communication, strategic and operational leadership.

Responsibilities

• Lead Revenue Recovery products under the Denials umbrella (DRG/DRGV, Medical Necessity Denials, ED Downgrades) and drive quantifiable results.
• Set departmental goals, financial targets, and KPIs aligned with company objectives.
• Define strategic direction and drive continuous improvement with senior leadership.
• Develop and monitor quality and productivity metrics and benchmarks.
• Create training materials and SOPs; oversee onboarding and ongoing staff education.
• Hire, train, and manage staff; oversee performance reviews and workload distribution.
• Coordinate cross-functional resources to address client action plans and projects.
• Ensure HIPAA/compliance knowledge is current and enforced across the team.

Skills

Leadership

Healthcare reimbursement

DRG coding

Regulatory compliance

Data analytics

Education

Bachelor’s degree in HIM/Healthcare Administration/related field

Master’s degree preferred

Job description

WHO WE ARE

EnableComp earned its reputation in the toughest corners of the revenue cycle by solving the complex claims no one else could. We developed Complex Revenue Intelligence™ (CRI), a smarter approach to predict and prevent revenue loss. Powered by the e360 RCM® AI-driven platform and the most expansive complex revenue cycle data set, today EnableComp helps more than 1,000 hospitals nationwide recover $3 billion annually from complex claims, denials, and revenue recovery. By cutting through complexity, we help hospitals thrive, resulting in recognition as Black Book's #1 Specialty RCM provider for complex claims and revenue integrity in 2024 and 2025, a multi-year Top Workplaces honoree, and a SOC 2 Type II and HITRUST e1-certified platform.Our Vision is to empower healthcare providers to focus on patient care, not revenue cycle complexity. Our Mission is to uncover what others miss-turning every client dollar recovered into insight that helps prevent future loss. We live our Core Values of Uncompromising Integrity, Ecstatic Clients, and Empowered Team Members by operating with trust, accountability, and a "we before me" mindset. We pursue Innovation and Profitable Growth through continuous improvement and thoughtful problem-solving, and we believe work should include Fun-celebrating success, recognizing our people, and maintaining healthy work-life balance.

POSITION SUMMARY

The VP, Revenue Recovery is responsible for providing leadership and supervision to the Revenue Recovery products under the Denials umbrella, including Diagnosis-Related Group (DRG & DRGV), and Medical Necessity Denials and Emergency (ED) Downgrades, for the purpose of obtaining quantifiable results and setting priorities for direct reports. Leads dedicated product and service teams across Revenue Recovery to deliver best-in-class results to clients while ensuring clinical coding integrity and regulatory compliance. The VP possesses strong leadership and communication skills and reports regularly to senior management on obstacles, challenges, and opportunities that impact the Company's revenue projections. The VP is accountable for developing and supporting leadership within the department, while driving operational performance, client satisfaction, and continuous improvement across Revenue Recovery.

JOB RESPONSIBILITIES

• Acts as a subject matter expert in EnableComp Revenue Recovery related products, including DRG & DRGV, and Medical Necessity Denials & ED Downgrades.
• Defines and establishes departmental goals, financial targets, and key performance indicators that align with company objectives.
• Assists in setting the strategic direction of Revenue Recovery and identifies areas of continuous improvement in conjunction with the senior leadership team.
• Oversees the development of quality and productivity metrics and benchmarks for Revenue Recovery functions based on industry standards and internal benchmarks.
• Acts as a key resource in the creation, communication, and training of process changes and operational best practices within Revenue Recovery.
• Ensures processes and inventory are in place to meet monthly, quarterly, and annual revenue expectations for the company.
• Is responsible for hiring, staff training, and oversight, including annual goal planning, performance reviews, workload distribution, and regular monitoring of team performance. Directs and motivates staff.
• Coordinates resources throughout the organization to address action plans for assigned clients and projects.
• Collaborates cross-functionally with other senior leaders to guide corporate planning, resource allocation, and strategic partnerships.
• Sets daily priorities to ensure the most impactful work is prioritized and appropriately staffed.
• Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders with corrective action plans for variances when appropriate. Ensures these metrics are cascaded throughout the organization.
• Leads in explaining variances to management on a regular basis regarding DRG reviews, billing activity, and revenue metrics.
• Researches and analyzes operational processes and systems to identify process improvement opportunities and SOP enhancements.
• Participates in high-level client relationships and ensures client satisfaction through regular performance updates, collaboration, and resolution of escalated concerns.
• Oversees the development of training materials and evaluates trends to support onboarding, ongoing education, and quality improvement.
• Develops a high-performing team through effective leadership, coaching, and accountability to build a high-performing, scalable organizational structure.
• Maintains a current working knowledge of all related regulatory and compliance requirements (including HIPAA and coding guidelines) and ensures staff adherence through training, process updates, and policy alignment.
• Maintains a strong knowledge of DRG coding, clinical documentation, and reimbursement methodologies.
• Performs other duties as required.

REQUIREMENTS & QUALIFICATIONS

• 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’ 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 effectively at both strategic and operational levels.
• Timely and regular attendance.
• Equivalent combination of education and experience will be considered
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

SPECIAL CONSIDERATIONS & PREREQUISITES

• Practices and adheres to EnableComp’s Core Values, Vision and Mission.
• Travel 0-10%; general office environment
• Strong and professional written and oral communications skills.
• Has worked in a production environment and can meet deadlines. Provide examples of goals measurement for yourself and your team.
• Excellent people skills to interface with multiple internal stakeholders.
• Proven success in obtaining quantifiable results from and setting priorities for direct reports. Describe how you manage to individual goals.
• Organized and can handle multiple projects simultaneously.
• Health care experience and familiarity with payer or provider data sets.
• Ability to set and manage multiple priorities among several teams.
• Experience communicating obstacles & challenges and developing action plans to present to management. Provide examples.

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.

EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that investing in our employees is the key to our success, and we are dedicated to providing them