Prebill Compliance Specialist

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.

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.

Position Details:

• 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

Our Benefits:

• Medical Coverage: Choice of HMO and PPO medical plans to meet the needs of you and your family
• Dental & Vision: Comprehensive dental and vision coverage
• 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

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!