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Location: Houston Type: Direct Hire Job #10321 Prior Authorization Specialist (fully remote, must reside in Texas) Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Job Scope: The Prior Authorization Specialist is responsible for obtaining prior authorizations and recurring authorizations for assigned patient accounts, while communicating with payers, providers, and patient/patient families when needed. Requirements: 2+ years of prior authorization experience 2+ years of insurance verification 2+ years working with an EMR or Practice Management Software Demonstrated an ability to problem solve collaborate in a team setting Compensation: $15/hr – $19/hr based upon skills and experience. For more information about this opportunity and to explore other positions, please visit our website at v3recruiters.com. Apply Now

Location: Houston Type: Direct Hire Job #10255 Medical Collector – Onsite Houston Galleria area Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Job Scope: The Medical Collector is responsible for the follow-up and collection of assigned patient accounts by contacting, insurance companies, patients, and government payors to resolve all outstanding balances. *Remote position, must reside in Texas. Requirements: 3+ years of medical billing or medical collections experience 2+ years of appeals 2+ years working with an EMR or Practice Management Software Demonstrated an ability to problem solve collaborate in a team setting   Key Words: appeals, denials, medical collections, patient accounts, medical billing, revenue cycle For more information about this opportunity and to explore other positions, please visit our website at v3recruiters.com. Apply Now

Location: Houston Type: Direct Hire Job #10007 Clinical Documentation Improvement Specialist (Remote) Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Job Summary The Clinical Documentation Specialist communicates with providers, case managers, coders, and other healthcare team members to facilitate comprehensive medical record documentation to reflect clinical treatment, decisions, and diagnoses for inpatients/residents.  The CDS utilizes the hospital's designated clinical documentation system to identify opportunities for physician and hospital outcomes, provides or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues and acts as a consultant to coders when additional information or documentation is needed to assign the correct diagnosis related group (DRG).  Responsible for the day-to-day evaluation of documentation by the medical staff and healthcare team, and gathers and analyzes information pertinent to documentation findings and outcomes.  Maintains working knowledge of DRGs and understanding of medical necessity process. Knowledgeable of federal, state, and other payers' regulations, requirements, and criteria.  Qualifications Bachelor s degree in nursing required. Graduate from a nationally accredited nursing program preferred. CCDS certification required. Three years of recent clinical nursing experience required. Experience in case management, utilization management, and/or coding preferred. Currently holds an unencumbered RN license.   Apply Now

Location: Houston Type: Direct Hire Job #10006 Inpatient Coder (Remote) Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Qualifications 2 years of inpatient coding in an acute hospital setting required. AHIMA coding credentials – CCS or RHIT Position Responsibilities Reviews and interprets health record documentation to accurately identify pertinent primary and secondary diagnosis and procedures that require code and DRG assignment for proper billing. Assesses high risk quality cases to accurately trigger pre-bill coding review process. Abstracts and complies clinical data elements such as attending physician, surgeon, consultants, ED physician, birth weight, etc. according to guidelines. Validates and initiates correction on patient status, admit and discharge dates and discharge disposition for calculation of correct DRG and length of stay for correct reimbursement. Queries physician when documentation in the record is ambiguous, inadequate, unclear or incorrect for coding and compliance purposes. Apply Now

Location: Houston Type: Direct Hire Job #6641 Revenue Cycle Manager Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Job Scope:  Prepare revenue cycle financial analysis including aged accounts. Monitor and assesses KPI’s in order to improve efficiencies. Analyze insurance denial trends and create front end edits/rules to help increase clean claim rate, reduce denial rates and increase cash collections. Maintains strong understanding of payor related changes across all states/markets Provide weekly status reports on projects Prepare data on payor denials Meet/exceed budget and profitability goals Position Requirements: Minimum of 5 years experience in healthcare medical Revenue Cycle environment College degree desired Prior presentation skills to Executive leadership teams on KPI and leadership priorities Excellent relationship building skills and aptitude for working collaboratively with cross-functional groups Strong working knowledge of payor denials and payors Requirements: 7+ years of medical billing or medical collections experience 3+ years of RCM management   For consideration, simply click: “Apply Now” Apply Now

Location: Houston Type: Direct Hire Job #6640 HCC Risk Adjustment Coder (Remote) Why V3 Group: Grow your career. Advance in your field. Earn more. Find the latest healthcare jobs that fit your unique qualifications, experience, and skills! Scope of Work: Remote Independent Contractor HCC Risk Adjustment Coders provide services to perform code abstraction using the Coding Guidelines for ICD-9-CM/ICD-10-CM. Projects include Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation). Project Responsibilities: Perform code abstraction and/or coding quality audits of medical records to ensure ICD-9-CM/ICD-10-CM codes are accurately assigned and supported by clinical documentation Maintain current knowledge of ICD-9-CM/ICD-10-CM codes, CMS documentation requirements, and state and federal regulations Maintain a minimum 95% accuracy on coding quality audits Meet minimum productivity requirements as outlined by the project terms Handle other related duties as required or assigned Requirements: Certified Coder through AHIMA or AAPC 2-3+ years of HCC coding experience Apply Now