Billing Specialist

Pathways Healthcare

. Audit patient accounts for billing accuracy, completeness, and compliance with payer requirements .

Posted 9/30/2026full-timeWestwood • Massachusetts • United StatesMid-LevelSenior💰 $23 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare billing processes, including Medicare, Medicaid, and commercial payer requirements, while ensuring accuracy and compliance in account audits. Strong analytical skills support effective problem-solving and collaboration across departments to resolve billing discrepancies and improve revenue cycle efficiency.

Highest-signal resume keywords

Healthcare Billing ExperienceMedicare Part B KnowledgeEOB InterpretationAnalytical Problem-SolvingAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Billing AuditAccounts ReceivableRevenue Cycle ManagementDenial ReviewDocumentation Accuracy

Soft Skills

CollaborationTime ManagementIndependent WorkCommunication

Tools & Technologies

Microsoft OfficeElectronic Medical Record SystemsHomecare Homebase (HCHB)InovalonClearinghouses

Industry Keywords

Home HealthHospiceMedicare AdvantageMedicaidHealthcare Reimbursement

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

High school diploma or equivalent
Previous healthcare billing, accounts receivable, claims, audit, or revenue cycle experience
Experience in Home Health, Hospice, Medicare Part B, or another Medicare-focused healthcare billing environment
Strong understanding of healthcare reimbursement, insurance requirements, denials, and accounts receivable processes
Ability to review patient accounts and identify billing discrepancies or missing information
Ability to interpret EOBs, remittance advice, denial codes, claim status responses, and payer correspondence
Strong analytical and problem-solving skills
Strong attention to detail and accuracy
Ability to manage multiple accounts and priorities while meeting deadlines
Ability to work independently and collaborate effectively across departments
Proficiency with Microsoft Office and healthcare billing or electronic medical record systems
Preferred: Home Health or Hospice revenue cycle experience
Preferred: Medicare Part B billing or auditing experience
Preferred: Knowledge of Medicare Home Health and Hospice billing requirements
Preferred: Experience reviewing denials, underpayments, and aging accounts
Preferred: Experience with Medicare Advantage, Medicaid, and commercial insurance plans
Preferred: Experience with Homecare Homebase (HCHB), Inovalon, clearinghouses, or similar revenue cycle systems
Preferred: Experience conducting billing audits or quality reviews

Benefits

Comp & perks

3 weeks PTO annually accrued
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 insurance
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