Medical Billing – Qualification Specialist Job at Beacon Hill (Plymouth Meeting)

New

Clinical Documentation Integrity (CDI) Analyst

Applies clinical expertise and knowledge of health care workflows in order to ed...

Location

United States , Shaker Heights

Salary:

79331.00 - 124051.00 USD / Year

University Hospitals

Expiration Date

Until further notice

Requirements

Other Accredited Program: Diploma in Nursing or in Health Information Management
Associate's Degree preferably in Health Information Management or Nursing
Bachelor's Degree preferably in Health Information Management or Nursing
Doctorate Degree in Medicine
3+ years CDI experience as a concurrent reviewer
Extensive clinical knowledge and understanding of pathology/physiology
Strong critical thinking skills
Demonstrates comprehension of Case Mix Index (CMI)
Knowledge of age-specific patient needs and the elements of disease processes and related procedures
Excellent written and verbal communication skills

Job Responsibility

Performs post-discharge, final coded, pre-bill reviews of targeted records identified for second-level review for opportunity to accurately capture patient acuity, severity of illness, risk of mortality, and DRG assignment in compliance with industry rules and regulations
Documents SLR findings within CDI application
Serves as a role model and resource for CDI team members
Maintains a summary of opportunities identified through second level review for feedback and education with the CDI team
Periodically review the criteria established for cases triggering a second level review and recommend updates or modifications to the criteria to assist in identifying areas of opportunity
Is actively engaged in quality and process improvement efforts
Performs other duties as assigned
Complies with all policies and standards
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients

What we offer

$5,000 Sign on Bonus
healthcare
dental
vision
retirement plan options
additional offerings

Fulltime

Market Access Specialist

Enable therapeutic innovation to become market realities for patients and health...

Location

Australia

Salary:

Not provided

Product Life Group

Expiration Date

Until further notice

Requirements

Degree in Economics, Pharmacy, or a Life Sciences discipline
Postgraduate qualifications in Biotechnology, Business, Health Economics, Epidemiology, Statistics, or Public Health (preferred)
Minimum of 5 years’ relevant commercial experience in Australia in market access, health outcomes, or health economics (consulting or industry)
Minimum of 3 years’ consulting experience
Strong understanding of the Australian and New Zealand healthcare and reimbursement systems, including HTA principles and policy context
Experience engaging with Australian reimbursement stakeholders such as PBAC, MSAC, HTA Section, and HPP
Demonstrated ability to design and execute market access strategies and respond to complex strategic challenges
Experience in both qualitative and quantitative research methodologies
Excellent analytical, numerical, written, and verbal communication skills
Ability to translate complex data and technical analysis into clear, accessible outputs for clients

Job Responsibility

Deliver high-quality market access, research, and market intelligence consulting services across the pharmaceutical, biotech, and medical device sectors
Lead and contribute to reimbursement submissions and strategic market access projects, including PBAC, MSAC, PL and PHARMAC
Conduct rigorous desk-based secondary research and interpret insights from primary research to support strategic recommendations
Support and lead projects across product feasibility, market identification, portfolio analysis, due diligence, competitive intelligence, stakeholder mapping, and pricing/reimbursement strategy
Provide strategic advice on reimbursement, pricing, and risk-sharing strategies, including identification of risks and mitigation pathways for HTA submissions
Act as a subject matter expert and lead project teams where required, ensuring projects are delivered to scope, timeline, quality, and budget
Engage directly with clients to deeply understand their needs and translate discussions into clear proposals and robust scopes of work
Mentor and support junior team members through training, guidance, and technical oversight
Strengthen long-term client relationships to support retention, repeat work, and expansion of the MPA service offering
Represent the company externally to build networks, credibility, and market presence

What we offer

Work alongside leading experts in market access, health economics, and evidence strategy
Contribute to meaningful projects that improve patient access to innovative therapies
Benefit from a collaborative culture focused on professional growth and knowledge sharing
Gain exposure to diverse clients across pharmaceuticals, biotechnology, and medical devices
Be part of a mission-driven organisation helping clients translate therapeutic innovation into real-world outcomes

Clinical Coding Specialist

We're looking for a Clinical Coding Specialist with deep expertise in Australian...

Location

Australia , Melbourne

Salary:

Not provided

Heidi

Expiration Date

Until further notice

Requirements

3-5+ years of professional medical coding experience in Australian hospital, clinic, or health system environments
HIMAA certification in Clinical Coding or equivalent qualification (university/TAFE clinical coding certificate)
Expert-level knowledge of ICD-10-AM/ACHI and Australian Coding Standards (ACS) across multiple specialties
Strong understanding of DRG (Diagnosis Related Groups) and AR-DRG classification system
MBS knowledge and understanding of Medicare Australia billing requirements
Multi-specialty coding experience including public/private hospital, GP, emergency department, and specialty clinic coding
Experience with coding audits and quality assurance processes, including accuracy measurement and improvement initiatives
Familiarity with EHR systems such as Epic, Cerner, Best Practice, Medical Director, Genie, or hospital PAS systems
Analytical skills with ability to identify coding patterns, trends, and systematic issues
Adaptability to work in a fast-paced technology environment and translate traditional coding processes into innovative AI-powered solutions

Job Responsibility

Lead medical coding validation for AI-generated documentation, ensuring accurate application of ICD-10-AM, ACHI, and MBS item numbers across diverse clinical scenarios in both public and private settings
Develop coding guidelines and protocols that translate complex Australian Coding Standards (ACS) into systematic processes our AI can learn and apply consistently
Conduct quality audits of AI-coded documentation, identifying patterns, gaps, and opportunities for improvement in coding accuracy, DRG assignment, and compliance
Collaborate with engineering teams to translate medical coding expertise into technical requirements, validation rules, and system improvements
Work directly with Australian clinicians to understand documentation patterns, clinical decision-making, and coding challenges across private hospitals, and public health systems, and GP practices
Ensure regulatory compliance with Department of Health coding standards, Medicare Australia requirements, DVA guidelines, and private health insurer specifications
Analyze coding data and metrics to identify trends, accuracy patterns, and areas for system optimization across our Australian customer base
Stay current with coding updates including annual ICD-10-AM/ACHI releases, MBS schedule changes, and ACCD standards updates
Support customer implementations by providing coding expertise during enterprise client onboarding and troubleshooting

What we offer

Flexible hybrid working environment, with 3 days in the office
A generous personal development budget of $500 per annum
Learn from some of the best engineers and creatives, joining a diverse team
Become an owner, with shares (equity) in the company, if Heidi wins, we all win
The rare chance to create a global impact as you immerse yourself in one of Australia’s leading healthtech startups
If you have an impact quickly, the opportunity to fast track your startup career

Fulltime

Patient Registration specialist

We are looking for a detail-oriented and compassionate individual to join our he...

Location

United States , Kalamazoo

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Strong customer service skills with the ability to communicate compassionately and professionally
Proficiency in data entry with attention to accuracy and efficiency
Familiarity with medical terminology and insurance verification processes
Ability to perform under pressure in a fast-paced healthcare environment
Effective teamwork skills to collaborate with hospital staff and departments
Basic math skills for handling financial transactions and patient payments
High school diploma or equivalent educational qualifications
Minimum of 2 years of experience in a medical setting, preferably in registration or admitting roles

Job Responsibility

Accurately register patients in the emergency department, handling inpatient and outpatient admissions with attention to detail
Input patient demographic and financial information into the hospital's computer system efficiently and accurately
Verify insurance coverage and eligibility to ensure proper billing processes
Collect co-pays and other patient payments in a courteous and efficient manner
Conduct interviews with patients or their families to gather necessary registration information
Prepare and manage registration forms, admissions paperwork, and other related documentation
Provide clerical and secretarial support to assist with hospital operations
Assist patients with navigating the hospital, escorting them to designated areas when needed
Monitor bed availability in the emergency department and communicate updates to relevant staff
Support transfer or discharge procedures, ensuring smooth transitions for patients

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Hampstead

Salary:

16.00 - 24.00 USD / Hour

CVS Health

Expiration Date

August 22, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state, click here to learn more
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner

Job Responsibility

Support the pharmacy team in delivering operational and service excellence within your store
Assist patients and customers to deliver an exceptional experience
Assist the pharmacy team to ensure pharmacy operations run smoothly, prescriptions are filled promptly, safely, and accurately, and provide caring service that exceeds patient expectations
Operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs), best practices, and effective communication
Complete required training and satisfy registration, licensing, and certification requirements
Contribute to safe and effective operations of the pharmacy
Follow all company SOPs at each workstation to help Pharmacists manage and improve patient health
Follow pharmacy workflow procedures at each pharmacy workstation for safe and accurate prescription fulfillment
Contribute to positive patient experiences by showing empathy and genuine care
Complete basic inventory activities

What we offer

Dental
Vision
Wellness resources
Employee discounts
Access to certain voluntary benefits
Other programs

Parttime

New

Pharmacy Technician

At CVS Health, we are focused on transforming health care for our customers and ...

Location

United States , Peabody

Salary:

17.00 - 27.00 USD / Hour

CVS Health

Expiration Date

August 01, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

Medical insurance
Dental insurance
Vision insurance
Paid time off
Retirement savings options
Wellness programs

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Palmer

Salary:

17.00 - 27.00 USD / Hour

CVS Health

Expiration Date

August 01, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

dental
vision
wellness resources
employee discounts
access to certain voluntary benefits
and other programs

Parttime

New

Site Engineer

Are you an experienced Site Engineer looking to take the next major step in your...

Location

United Kingdom , Southampton

Salary:

50000.00 - 65000.00 GBP / Year

Randstad

Expiration Date

July 15, 2026

Requirements

Degree or HNC/HND in Civil Engineering or a closely related construction discipline
Proven experience setting out on civil engineering or major infrastructure projects (e.g., groundworks, heavy RC structures, complex drainage, or highways)
Fully competent in using modern robotic surveying equipment and AutoCAD software
Valid CSCS card is essential
SMSTS/SSSTS and First Aid are highly desirable
A full UK driving license is required
Candidates must be eligible to live and work in the UK

Job Responsibility

Setting Out & Surveying: Establishing accurate control points and setting out complex works using modern EDMs, Total Stations, and GPS equipment
Quality Assurance: Managing strict quality control on-site, including maintaining comprehensive QA records, managing RFI (Request for Information) processes, and resolving complex technical queries
Site Supervision & Leadership: Collaborating closely with the Sub Agent and Site Manager to oversee subcontractors, ensuring works align perfectly with design drawings and specifications
Health & Safety: Promoting a rigorous zero-harm culture on-site, ensuring all engineering activities comply with strict H&S regulations

What we offer

Car allowance/company car
Enhanced pension
Private healthcare
Structured pathway for career progression into management
Full financial support and mentorship toward ICE/chartership if desired

Select Country

Medical Billing – Qualification Specialist

Requirements

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