Billing Specialist — Long-Term Care Pharmacy

Polaris Pharmacy Services; Fort Lauderdale (FL); Remote; USD 42,000 - 58,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

401(k)

Company paid life insurance

Disability insurance (short and long)

Tuition reimbursement

Personal Time Off (PTO)

Competitive pay with annual reviews

Career growth opportunities

Annual on-site flu vaccines

Job summary

Polaris Pharmacy Services is hiring a Billing Specialist to manage nursing home, assisted living, and private-pay statements. You will handle third-party billing, PPS/FFS processes, and payor verification to ensure accurate patient accounts.

Ideal candidates have a high school diploma and at least two years in pharmacy billing, preferably long-term care, with proficiency in Framework LTC and basic Sage knowledge.

Qualifications

• High School diploma or equivalent required.
• Two years pharmacy billing experience preferred (long-term care experience preferred).
• Knowledge of Framework LTC and 10-key number entry is preferred.
• Sage knowledge is a plus.

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.
• KnowDual Coverage, MCR D, and Commercial plans for 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.
• Create statements and end-of-month summaries.
• Understand and work with residents on account balances.
• Follow HIPAA and other government regulations.
• Other duties as assigned by Billing Manager.

Skills

English proficiency

Fast-paced

Basic computer

Math skills

MS Word

MS Excel

MS Outlook

Attention to detail

Organization

Adaptability

Education

High School diploma or equivalent

Tools

Sage

Framework LTC

10-key entry

Job description

Polaris Pharmacy Services is hiring a Billing Specialist to manage nursing home, assisted living, and private-pay statements. You will handle third-party billing, PPS/FFS processes, and payor verification to ensure accurate patient accounts.

Ideal candidates have a high school diploma and at least two years in pharmacy billing, preferably long-term care, with proficiency in Framework LTC and basic Sage knowledge.