Palliative Care Revenue Cycle Specialist (Medicare Part B)

About Us: 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. We are proud to be ranked #22 Best Places to Work in Massachusetts and #51 Best Places to Work in the United States! 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. Main Office location: Westwood, MA Job Type: Full Time Schedule: Monday - Friday; 8:30 AM - 5:00 PM Hybrid or Remote Schedule Supported Responsibilitie s: 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 Medical Coverage: Choice of HMO and PPO medical plans to meet the needs of you and your family 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! #J-18808-Ljbffr