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Medicaid Pending Billing Specialist - Remote

Role overview

Qualifications

  • Detail-oriented professional
  • Effective communication skills
  • Ability to manage billing processes
  • Knowledge of Medicaid regulations

Responsibilities

  • Manage the pending queue for Medicaid claims, ensuring all claims are processed efficiently and accurately.
  • Resolve claim issues by identifying discrepancies and implementing solutions to facilitate timely payments.
  • Rebill Medicaid claims as necessary, ensuring compliance with relevant regulations and guidelines.
  • Serve as a liaison between POLARIS PHARMACY SERVICES and Medicaid representatives, facilitating communication and resolution of billing issues.

Key facts

Other skills

  • Detail Oriented
  • Communication
  • Problem Solving
  • Teamwork

About the company

Polaris Pharmacy Services logo

Polaris Pharmacy Services

Polaris Pharmacy Services, is a privately owned long-term and post-acute care pharmacy committed to delivering high-quality pharmacy services, exceptional customer experiences, and industry-leading value. Did you know that Polaris is the 5th largest LTC pharmacy in the U.S., delivering high-quality care to LTC, PACE, and Correctional facilities? Founded in 2015, Polaris operates 21 pharmacies across 29 states, serving 80,000+ residents and providing innovative solutions in packaging, reimbursement, workflow, and financial performance.

Company details

Company size1001 - 5000

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Job description

WHO WE ARE
At Polaris Pharmacy Services, we’re more than a pharmacy — we’re a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we’re raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.

Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job — we provide competitive pay, robust benefits, and genuine opportunities for career advancement.

If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.

Job Purpose
The Medicaid Pending Billing Specialist at POLARIS PHARMACY SERVICES is responsible for managing the billing process for Medicaid pending claims, ensuring timely resolution and rebilling. This role requires a detail-oriented professional who can effectively liaise with various stakeholders to facilitate appeals and provide financial assistance, while maintaining accurate documentation throughout the process.

Key Responsibilities:

  • Manage the pending queue for Medicaid claims, ensuring all claims are processed efficiently and accurately.
  • Resolve claim issues by identifying discrepancies and implementing solutions to facilitate timely payments.
  • Rebill Medicaid claims as necessary, ensuring compliance with relevant regulations and guidelines.
  • Serve as a liaison between POLARIS PHARMACY SERVICES and Medicaid representatives, facilitating communication and resolution of billing issues.
  • Handle appeals processes, working to overturn denied claims and secure payment.
  • Provide financial assistance guidance to patients and families, helping them navigate the complexities of Medicaid billing.
  • Maintain thorough and accurate documentation of all billing activities, ensuring records are up-to-date and accessible for auditing and reporting purposes.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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