[Hiring] Billing Specialist @Polaris Pharmacy Services
Role Description
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
- 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
Requirements
- 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
- 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
Benefits
- 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
