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Billing Specialist - Remote

Key Facts

Full time
English

Other Skills

  • Customer Service
  • Communication
  • Professionalism

Roles & Responsibilities

  • Knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care
  • Experience with third-party billing and claim resolution
  • Familiarity with insurance and Medicaid coverage
  • Ability to handle customer billing inquiries professionally

Requirements:

  • Process third-party billing, claim resolution, and adjudication
  • Manage FFS and PPS billing
  • Conduct census balancing and payor verification
  • Prepare daily, weekly, and monthly reports

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 SUMMARY:

The Billing Specialist is responsible for Nursing Homes, Assisted Living Facilities, Group Homes, and Private Pay statements.

 

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

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