VP, Revenue Recovery & Denials Strategy

EnableComp LLC; Franklin (TN); Remote; USD 180,000 - 260,000; Full time

Job summary

EnableComp seeks a VP of Revenue Recovery to lead the DRG/DRGV and Medical Necessity Denials teams, overseeing performance and ensuring regulatory compliance. You will set priorities, build cross-functional partnerships, and drive initiatives that improve client outcomes and revenue recovery.

The role requires strategic leadership, strong communication, and experience managing healthcare reimbursement programs within hospital networks. Travel up to 10% is expected.

Qualifications

• Bachelor's degree required; Master's preferred.
• CCS/RHIT/RHIA certifications preferred.
• 7–10 years leadership in healthcare reimbursement; 5+ years in clinical denials or inpatient claims.
• Experience with client-facing roles in healthcare; strong communicator.

Responsibilities

• Act as SME for EnableComp Revenue Recovery products (DRG & DRGV, Medical Necessity Denials & ED Downgrades).
• Define departmental goals, financial targets and KPIs aligned with company objectives.
• Set strategic direction for Revenue Recovery with senior leadership.
• Develop quality and productivity metrics and benchmarks for Revenue Recovery.
• Lead training, SOPs, and best practices within Revenue Recovery.
• Ensure processes and inventory meet monthly, quarterly and annual revenue expectations.
• Hire, train, and supervise staff; manage performance and workload distribution.
• Coordinate resources across the organization for clients and projects.
• Collaborate with cross-functional leaders on planning, resources and partnerships.
• Communicate variances and performance metrics to management; implement corrective actions.
• Foster onboarding, education, and quality improvement through training materials.
• Develop a high-performing team and scalable organizational structure.
• Maintain knowledge of HIPAA, coding guidelines, DRG methodologies, and payer rules.
• Travel 0–10% and work in a general office environment.

Skills

Leadership

Supervision

DRG & DRGV experience

Medical Necessity Denials

ED Downgrades

Regulatory compliance

HIPAA knowledge

Coding guidelines

Payer guidelines

Data reporting & analytics

Client relationships

Training & development

Strategic planning

Project management

Staff development

Communication skills

Education

Bachelor's degree in health information management / Nursing / Healthcare Administration / Business

Master's degree preferred

CCS / RHIT / RHIA certification preferred

Job description

EnableComp seeks a VP of Revenue Recovery to lead the DRG/DRGV and Medical Necessity Denials teams, overseeing performance and ensuring regulatory compliance. You will set priorities, build cross-functional partnerships, and drive initiatives that improve client outcomes and revenue recovery.

The role requires strategic leadership, strong communication, and experience managing healthcare reimbursement programs within hospital networks. Travel up to 10% is expected.