Billing Specialist (Morning to Mid Shifts)

Polaris Pharmacy Services

San Diego (CA)

On-site

USD 57,308,000 - 63,039,000

Full time

4 days ago

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Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Life insurance

Disability insurance

Tuition reimbursement

PTO

merit-based raises

Career growth

Flu vaccines

Referral bonus

Job summary

Polaris Pharmacy Services in San Diego, CA is seeking a Billing Specialist to manage Nursing Homes, Assisted Living, Group Homes, and Private Pay statements.

The role handles third-party billing, claim resolution, and adjudication, with duties including census balancing, payor verification, and HIPAA compliance; strong Excel/Word skills required.

Qualifications

High School diploma or equivalent required.
Two years pharmacy billing experience required (long-term care preferred).
Framework LTC knowledge and general computer skills preferred.
Knowledge of Sage preferred.

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 for Long Term Care.
Assist with customer billing inquiries in a courteous manner.
Enter fees and charges in Framework LTC.
Prepare daily, weekly, and monthly pre-bills and audits.
Create statements and EOM summaries.
Follow HIPAA and other government regulations.

Skills

English proficiency

Fast-paced environment

Basic computer skills

Math & analytics

MS Word, Excel, Outlook

Strong organization

Reliability

Problem solving

Shift flexibility

Adaptability

Education

High School diploma or equivalent

Tools

Framework LTC

Sage

Job description

Job Location: Polaris Pharmacy Services of San Diego - San Diego, CA 92123, Position Type: Full Time, Salary Range: $20.00 - $22.00 Hourly, Job Category: Admin - Clerical

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 / 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