VP, Revenue Integrity & DRG Optimization

EnableComp LLC; Franklin (TN); Remote; USD 120,000 - 180,000; Full time

Job summary

EnableComp LLC in Franklin, TN is seeking a senior leader to oversee Revenue Integrity and Revenue Recovery. You will define strategic goals, manage a high-performing team, and drive continuous improvement across DRG coding, denials management, and reimbursement processes.

Expect collaboration with senior leaders to align resources, monitor performance, and deliver timely updates to clients. Travel is limited, and the role emphasizes leadership, compliance, and process optimization.

Qualifications

• Bachelor's degree in health information management, Nursing, Healthcare Administration, Business, or related field required; Master's degree preferred.
• Active CCS/RHIT/RHIA strongly preferred.
• 7-10 years' leadership in healthcare reimbursement, with 5+ years in clinical denials or inpatient claims.
• Experience with client-facing roles and cross-functional collaboration.
• Strong knowledge of inpatient coding, DRG reimbursement, medical record auditing, and payer guidelines.

Responsibilities

• Act as SME in EnableComp Revenue Integrity products (DRG & DRGV, Medical Necessity Denials & ED Downgrades).
• Set and align departmental goals, financial targets, and KPIs with company objectives.
• Lead Revenue Recovery strategic direction and drive continuous improvement with senior leadership.
• Develop quality and productivity metrics and benchmarks for Revenue Recovery.
• Lead training, communication, and rollout of process changes and best practices within Revenue Recovery.
• Ensure processes and inventory support monthly, quarterly, and annual revenue targets.
• Hire, train, and supervise staff including annual goals and performance reviews.
• Coordinate cross-functional resources to address client action plans and projects.
• Guide corporate planning, resource allocation, and strategic partnerships with senior leaders.
• Set daily priorities to maximize impactful work and staffing alignment.
• Monitor key metrics and deliver performance reports with corrective actions when needed.
• Explain variances to management regarding DRG reviews, billing activity, and revenue metrics.
• Research and analyze processes to identify improvements and SOP enhancements.
• Maintain client relationships with regular performance updates and issue resolution.
• Develop training materials and monitor trends to support onboarding and quality improvement.
• Build a high-performing team through leadership, coaching, and accountability.
• Maintain knowledge of regulatory and compliance requirements (HIPAA, coding guidelines).
• Maintain knowledge of DRG coding, clinical documentation, and reimbursement methodologies.
• Other duties as required.

Skills

Leadership

Healthcare revenue cycle

DRG coding

Data analysis

Strategic planning

Staff development

Education

Bachelor's in HIM/Healthcare Admin

Master's degree preferred

Tools

Large-scale data/reporting tools

Job description

EnableComp LLC in Franklin, TN is seeking a senior leader to oversee Revenue Integrity and Revenue Recovery. You will define strategic goals, manage a high-performing team, and drive continuous improvement across DRG coding, denials management, and reimbursement processes.

Expect collaboration with senior leaders to align resources, monitor performance, and deliver timely updates to clients. Travel is limited, and the role emphasizes leadership, compliance, and process optimization.