Billing Specialist

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

Qualifications

QUALIFICATIONS/COMPETENCIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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
PHYSICAL DEMANDS The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
  • 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
  • The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role
HOLIDAY & PTO POLICY
  • 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.
Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.

BENEFITS for full time Employees

  • 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)
  • Competitive pay with annual performance reviews and merit-based raises
  • Career growth potential
  • Annual on-site voluntary Flu Vaccines
  • Employee referral bonus program
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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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