Vice President, Revenue Recovery (REMOTE)

POSITION SUMMARY

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