Related skills
hipaa revenue integrity drg drgv medical necessity denials📋 Description
- Lead DRG/DRGV revenue integrity and related denials.
- Set departmental goals, targets, and KPIs aligned with company objectives.
- Shape strategic direction of Revenue Recovery and drive improvements.
- Develop quality and productivity metrics for Revenue Recovery.
- Lead creation and training of process changes and best practices.
- Ensure processes/inventory meet revenue goals and oversee staffing/performance.
🎯 Requirements
- Bachelor’s degree in health info, nursing, healthcare administration or related field.
- Master’s degree preferred.
- Active CCS/RHIT/RHIA strongly preferred.
- 7–10 years leadership in healthcare reimbursement; 5+ years in clinical denials.
- Experience with client-facing roles and internal teams.
- Strong inpatient coding, DRG reimbursement, auditing, and payer guidelines.
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