Prebill Compliance Specialist

Job Description:

• Role: Prebill Compliance Specialist
• Rate: $18-$25/hour
• Main Office location: Westwood, MA
• Schedule: Monday-Friday (8:30-5:00pm)
• Job Type: Full Time

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

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.

What We Offer:

• 3 weeks PTO annually accrued and 1 week paid sick time!
• Paid Federal Holidays (8 observed annually)
• 401(k) Retirement Plan with employer match
• Blue Cross Blue Shield Medical (Choice of HMO/PPO), Dental, Principal Vision and Life insurance

• 100% company-paid short-term disability coverage

• Flexible Spending Accounts (FSA): Pre-tax accounts available for healthcare and dependent care expenses

• Professional Development & Training Opportunities

• Employee Assistance & Benefits Support through Bennie

• Voluntary Benefits including supplemental life, accident, and disability insurance

Pathways Healthcare is committed to providing exceptional care to our patients and fostering a positive work environment for our team members. If you're passionate about making a difference in people's lives and possess the required qualifications, we encourage you to apply for this exciting opportunity!

About Us:
 

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.

As one of the first home health agencies to adopt AI-assisted documentation, we're investing in tools that give our clinicians time back – saving5 to 10 hours per week! We have made a deliberate decisionnot to raise our productivity expectations, so the patientsand clinicians win in the end. Technology handles the paperwork and your clinical judgment stays at the center of every note!

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