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!