Palliative Care Revenue Cycle Specialist (Medicare Part B)

Why Join Pathways?

• Join a mission-driven home health and hospice organization where your work directly supports patient access and clinical care.
• Play a critical role in the financial health of our growing palliative care program.
• Be part of a collaborative, supportive team that values accuracy, accountability, and continuous improvement.
• Work in an organization that prioritizes compliance, process improvement, and operational excellence.

Position Details:

• Main Office location: Westwood, MA
• Job Type: Full Time
• Schedule: Monday - Friday; 8:30 AM - 5:00 PM
• Hybrid or Remote Schedule Supported

Responsibilities:

• Prepare, review, and submit Medicare Part B and commercial claims for palliative care services
• Ensure accurate CPT, HCPCS, and ICD-10 coding in accordance with CMS and payer guidelines
• Review provider documentation for billing compliance and completeness
• Monitor claim status and proactively resolve rejections, denials, and underpayments
• Submit corrected claims and appeals with appropriate supporting documentation
• Post payments and reconcile accounts receivable
• Maintain aging reports and support efforts to reduce Days in A/R
• Collaborate with Intake, Clinical, Credentialing, and Compliance teams to ensure proper billing setup and provider enrollment
• Stay current with CMS regulations and payer-specific changes
• Support audits and internal compliance initiatives
• Identify process improvement opportunities to enhance clean claim rate and revenue capture

Qualifications:

• High school diploma required; Associate’s or Bachelor’s degree preferred
• Minimum 2+ years of medical billing experience required
• Strong experience with Medicare Part B professional fee billing required
• Knowledge of CPT, HCPCS, ICD-10 coding, and CMS billing regulations
• Experience managing denials, appeals, and accounts receivable
• High attention to detail and strong organizational skills
• Comfortable collaborating across departments and communicating billing requirements
• Proficiency with EMR and billing systems; strong computer and technology skills
• Ability to prioritize and manage follow-ups in a fast-paced healthcare environment

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!