Billing Specialist - Remote

Summary

Polaris Pharmacy Services is a pharmacy services provider supporting long-term, post-acute, correctional, PACE, and specialty pharmacy care. The Billing Specialist manages billing for nursing homes, assisted living facilities, group homes, and private-pay accounts, including claims, insurance verification, statements, audits, and customer billing inquiries.

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

Skills

• 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
• High School diploma or equivalent required
• Two (2) years' pharmacy billing experience required
• May sit or stand seven (7) to ten (10) hours per day
• The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
• May be necessary to work extended hours as needed
• May lift and/or move up to 30 pounds
• 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

Qualifications

Must Haves

• 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
• High School diploma or equivalent required
• Two (2) years' pharmacy billing experience required
• May sit or stand seven (7) to ten (10) hours per day
• The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
• May be necessary to work extended hours as needed
• May lift and/or move up to 30 pounds

Nice to Haves

• 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

Benefits

• Fully Remote
• Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
• Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
• Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.
• Medical, Dental, and Vision insurance
• 401 (k) (available for Part Time & Full Time EEs)
• Company Paid Life insurance
• Short-term and Long-term disability insurance
• Tuition reimbursement
• Personal Time Off (PTO)
• Annual performance reviews and merit-based raises
• Career growth potential
• Annual on-site voluntary Flu Vaccines
• Employee referral bonus program