Prebill Compliance Specialist

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

Compensation & Benefits:

• Hourly Rate: $18.00 - $25.00
• 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!