Billing Specialist

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 – saving 5 to 10 hours per week! We have made a deliberate decision not to raise our productivity expectations, so the patients and clinicians win in the end. Technology handles the paperwork and your clinical judgment stays at the center of every note!

• Role: Billing Specialist - Home Health, Hospice & Part B
• Rate: $23-$26/hour
• Main Office location: Westwood, MA
• Schedule: Monday-Friday (8:30-5:00pm)
• Job Type: Full-Time

• →Audit patient accounts for billing accuracy, completeness, and compliance with payer requirements.
• →Review accounts prior to billing to identify missing documentation, authorization issues, eligibility concerns, coding discrepancies, or other billing barriers.
• →Review billed accounts for potential errors, payment discrepancies, denials, underpayments, or follow-up needs.
• →Audit billing notes, account activity, and supporting documentation to ensure appropriate follow-up has occurred.
• →Review remittance advice, EOBs, claim status information, payer responses, and denial reasons.
• →Research billing discrepancies and determine the appropriate next steps for resolution.
• →Identify trends in billing errors, denials, documentation gaps, or payer issues and escalate recurring concerns.
• →Work collaboratively with billing, prebill, intake, authorization, clinical, scheduling, and other departments to resolve account issues.
• →Monitor assigned work queues, reports, or account lists to ensure outstanding issues are addressed timely.
• →Review insurance changes and payer information for potential billing impact.
• →Assist with aging reviews, account reconciliation, and identification of accounts requiring correction, appeal, adjustment, or additional follow-up.
• →Ensure billing-related documentation and account notes are clear, complete, and accurate.
• →Support internal audits and revenue cycle quality-improvement initiatives.
• →Provide feedback and education to internal teams when recurring billing or documentation issues are identified.
• →Maintain knowledge of Medicare, Medicaid, Medicare Advantage, commercial payer, Home Health, Hospice, and Part B billing requirements applicable to assigned responsibilities.
• →Meet established productivity, accuracy, and account-resolution expectations.
• →Perform additional revenue cycle and billing audit duties as assigned.