Related skills
hipaa drg payer guidelines drgv medical necessity denials📋 Description
- Lead SME for Revenue Integrity products (DRG/DRGV) and denials.
- Define goals, financial targets, and KPIs aligned with objectives.
- Set strategic direction for Revenue Recovery with senior leaders.
- Oversee quality and productivity metrics for Revenue Recovery.
- Lead creation, communication, and training of best practices.
- Ensure processes and inventory enable revenue targets.
🎯 Requirements
- Bachelor’s in HIM, Nursing, Healthcare Admin, Business; Master’s preferred.
- Active CCS, RHIT, or RHIA preferred.
- 7–10 years in healthcare reimbursement; 5+ years in denials.
- Experience in client-facing internal teams.
- Inpatient coding, DRG reimbursement, auditing, payer guidelines.
- Experience with hospital revenue cycle environments and data tools.
🎁 Benefits
- Travel 0-10%; general office environment.
- Career growth and leadership development.
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