Prebill Compliance Specialist

Pathways Healthcare, Llc; Westwood (MA); On-site; USD 25,000 - 34,000; Full time

Benefits offered by this job

PTO 3 weeks

Paid sick time

401(k) with employer match

Medical coverage

Job summary

Pathways Healthcare, a leading home health and hospice organization, is seeking a Billing Specialist to audit and prepare claims, ensuring accuracy and timeliness in a fast-paced setting.

Responsibilities include outbound calls to resolve documentation needs, reviewing face-to-face notes, and running prebill reports to prevent denials, while collaborating with clinical and administrative teams to support patient care.

Qualifications

• High school diploma or equivalent is required.
• Strong customer service and professional communication skills, including comfort with outbound phone calls.
• Computer and technology savvy, with the ability to learn new systems quickly.
• Ability to multitask, prioritize, and manage follow-ups in a fast-paced environment.
• Thrives in a dynamic, forward-thinking organization with ongoing process improvements and change.

Responsibilities

• Audit and prepare home health and hospice claims to ensure accurate, compliant, and timely billing.
• Requires a high comfort level with making outbound calls to drive timely resolution of documentation and billing needs.
• Review face-to-face documentation, unsigned orders, and visit notes; follow up to resolve missing or incomplete information.
• Run daily and weekly prebill reports to identify billing issues and help prevent claim denials.
• Work closely with Clinical, Marketing, and Administrative teams to remove financial barriers and support patient care.
• Meet individual and team productivity goals while maintaining confidentiality and Pathways’ TRUST values.

Skills

Customer service

Outbound calls

Professional communication

Computer literacy

Education

High school diploma or equivalent

Job description

Pathways Healthcare is a leading, physician- and nurse practitioner-led home health and hospice organization, committed to redefining recovery through comprehensive, patient-centered care. Our innovative Medical Rehabilitation Program offers a meaningful alternative to institutional rehab, helping people heal at home, with dignity and purpose.

We are proud to have ranked in Boston Globe's Best Places to Work in Massachusetts and USA Today's Top Places to Work in the United States since 2023!

Why Join Pathways?

• Join a mission-driven home health and hospice organization where your work directly supports patient care and timely services.
• Be part of a collaborative, supportive team that values accuracy, accountability, and continuous improvement.
• Main Office location: Westwood, MA
• Job Type: Full Time
• Schedule: Monday - Friday
• Schedule: 8:30 AM - 5:00 PM

Responsibilities:

• Audit and prepare home health and hospice claims to ensure accurate, compliant, and timely billing.
• Requires a high comfort level with making outbound calls to drive timely resolution of documentation and billing needs.
• Review face-to-face documentation, unsigned orders, and visit notes; follow up to resolve missing or incomplete information.
• Run daily and weekly prebill reports to identify billing issues and help prevent claim denials.
• Work closely with Clinical, Marketing, and Administrative teams to remove financial barriers and support patient care.
• Meet individual and team productivity goals while maintaining confidentiality and Pathways’ TRUST values.

Qualifications:

• High school diploma or equivalent required
• Strong customer service and professional communication skills, including comfort with outbound phone calls
• Computer and technology savvy, with the ability to learn new systems quickly
• Ability to multitask, prioritize, and manage follow-ups in a fast-paced environment
• Thrives in a dynamic, forward-thinking organization with ongoing process improvements and change
• Hourly Rate: $18.00 - $25.00
• Medical Coverage: Choice of HMO and PPO medical plans to meet the needs of you and your family
• Life Insurance: Employer-provided life insurance for added peace of mind
• Paid Time Off:
• 3 weeks of PTO annually, accrued throughout the year
• 4 weeks of PTO annually accrued throughout the year, after two years of service
• Sick Time: 1 week (40 hours) of paid sick time per year
• Short-Term Disability: 100% company-paid short-term disability coverage
• Flexible Spending Accounts (FSA): Pre-tax accounts available for healthcare and dependent care expenses
• 401(k) Retirement Plan with employer match
• Employee Assistance & Benefits Support through Bennie
• Voluntary Benefits including supplemental life, accident, and disability insurance
• 8 Paid Holidays observed annually
• Professional Development & Training Opportunities