VP, Revenue Integrity & Optimization

EnableComp LLC; United States; Remote; USD 140,000 - 210,000; Full time

Job summary

EnableComp LLC seeks an experienced Revenue Integrity leader to drive DRG coding excellence, Medical Necessity Denials, and ED Downgrades, ensuring optimal reimbursement and regulatory compliance.

You will set departmental goals, build a high-performing team, and partner with senior leaders to guide strategic planning, resource allocation, and process improvements across Revenue Recovery.

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, with 5+ years in clinical denials or inpatient claims environments.
• Experience in client-facing or client support roles and navigating hospital revenue cycles.

Responsibilities

• Act as a subject matter expert in EnableComp Revenue Integrity products, including DRG/DRGV and Medical Necessity Denials & ED Downgrades.
• Define and establish departmental goals, financial targets, and KPIs aligned with company objectives.
• Lead strategic direction of Revenue Recovery and drive continuous improvement with senior leadership.
• Develop quality/productivity metrics and benchmarks for Revenue Recovery functions.
• Create training resources and disseminate process changes and best practices within Revenue Recovery.
• Hit monthly, quarterly, and annual revenue targets and ensure proper staffing.

Skills

Leadership

Healthcare experience

Strategic planning

Team management

Data analysis

Education

Bachelor’s degree in health information management, nursing, healthcare administration, business, or related field

Master’s degree preferred

Job description

EnableComp LLC seeks an experienced Revenue Integrity leader to drive DRG coding excellence, Medical Necessity Denials, and ED Downgrades, ensuring optimal reimbursement and regulatory compliance.

You will set departmental goals, build a high-performing team, and partner with senior leaders to guide strategic planning, resource allocation, and process improvements across Revenue Recovery.