Billing Specialist
Polaris Pharmacy Services
Summary
The Billing Specialist is responsible for Nursing Homes, Assisted Living Facilities, Group Homes, and Private Pay statements.
Job description
Duties/Responsibilities
- Process third-party billing, claim resolution, and adjudication
- Manage FFS and PPS billing
- Conduct census balancing and payor verification
- Verify insurance and Medicaid coverage
- Knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care
- Assist with all customer billing inquiries in a courteous and professional manner
- Enter fees and charges in Framework LTC
- Prepare daily, weekly, and monthly pre-bills and account audits
- Prepare daily, weekly, and monthly reports
- Create statements and EOM summaries
- Understand and work with residents on account balances
- Follow all applicable government regulations including HIPAA
- Other duties as deemed necessary by Billing Manager
Required Skills/Abilities
- Able to read, write, speak, and understand the English language
- Able to work in a fast-paced environment
- Basic computer knowledge skills required
- Basic math and analytical skills
- Proficient in Microsoft Word, Excel, and Outlook required
- Good organization/Attention to detail
- Able to work at a moderate speed
- Reliable
- Problem solver
- Able to work various shifts and days
- Adaptability to an ever-changing environment
Education and/or Experience
- High School diploma or equivalent required
- Two (2) years' pharmacy billing experience required (long-term care preferred)
- Framework LTC & General computer knowledge & 10-key Number Entry preferred
- Knowledge of Sage preferred
Requirements
- High School diploma or equivalent required
- Two (2) years' pharmacy billing experience required
- Proficient in Microsoft Word, Excel, and Outlook required
- Basic computer knowledge skills required
- Basic math and analytical skills
- Able to read, write, speak, and understand the English language
- Able to work in a fast-paced environment
- Good organization/Attention to detail
- Reliable
- Problem solver
- Able to work various shifts and days
- Adaptability to an ever-changing environment
- Framework LTC & General computer knowledge & 10-key Number Entry preferred
- Knowledge of Sage preferred
- Long-term care experience preferred
Benefits
- Medical, Dental & Vision
- 401(k)
- Company Paid Life Insurance
- Short-term Disability Insurance
- Long-term Disability Insurance
- Tuition Reimbursement
- Paid Time Off
- Paid Holidays
- Sick Days
- Employee Referral Bonus Program
- Annual Performance Reviews
- Career Growth Potential
- Flu Vaccines
Company overview
Polaris Pharmacy Services is a privately owned long-term and post-acute care pharmacy company founded in 2015, headquartered in Fort Lauderdale, Florida. As the fifth largest long-term care pharmacy in the United States, Polaris operates 21 pharmacies across 29 states, serving over 80,000 residents in long-term care, PACE (Program of All-Inclusive Care for the Elderly), and correctional facilities. The company specializes in providing comprehensive pharmacy solutions including medication dispensing, clinical support, formulary management, prior authorization services, and innovative technology platforms like PolarisConnect and PolarisDirect. With a workforce of 1,001-5,000 employees, Polaris emphasizes personalized service, regulatory compliance, and cost containment strategies while maintaining a local, independently owned structure that allows for swift decision-making. Their mission focuses on delivering exceptional pharmacy services, clinical expertise, and technological innovation to enhance patient care and facility operations across diverse healthcare settings.