Billing Specialist (Morning to Mid Shifts)

POLARIS PHARMACY SERVICES OF SAN DIEGO LLC; San Diego (CA); In loco; USD 48.000 - 60.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical insurance

401(k) program

Paid holidays

Paid time off (PTO)

Merit-based raises

Descrizione del lavoro

Polaris Pharmacy Services of San Diego LLC is hiring a Billing Specialist to handle nursing homes, assisted living facilities, group homes and private pay statements. The role focuses on third-party billing, claim resolution, adjudication and payor verification to ensure accurate invoicing.

You're expected to have a High School diploma, at least two years of pharmacy billing experience, and proficiency with Framework LTC, Sage, and 10-key entry. The position offers full-time hours and benefits.

Competenze

• Reads, writes, speaks and understands English.
• High school diploma or equivalent required.
• Two years pharmacy billing experience preferred.

Mansioni

• Process third-party billing, claim resolution, and adjudication.
• Manage FFS and PPS billing.
• Conduct census balancing and payor verification.
• Verify insurance and Medicaid coverage.
• 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.
• Understand residents’ account balances and follow HIPAA.

Conoscenze

English proficiency reading/writing

Attention to detail

Basic math

MS Word

MS Excel

MS Outlook

Organization

Problem solving

Adaptability

Multi-tasking

Formazione

High School diploma or equivalent

Strumenti

Framework LTC

Sage

10-key entry

Descrizione del lavoro

WHO WE AREAt 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 adjudicationManage FFS and PPS billingConduct census balancing and payor verificationVerify insurance and Medicaid coverageKnowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term CareAssist with all customer billing inquiries in a courteous and professional mannerEnter fees and charges in Framework LTCPrepare daily, weekly, and monthly pre-bills and account auditsPrepare daily, weekly, and monthly reportsCreate statements and EOM summariesUnderstand and work with residents on account balancesFollow all applicable government regulations including HIPAAOther duties as deemed necessary by Billing ManagerQUALIFICATIONS/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 languageAble to work in a fast-paced environmentBasic computer knowledge skills requiredBasic math and analytical skillsProficient in Microsoft Word, Excel, and Outlook requiredGood organization/Attention to detailAble to work at a moderate speedReliableProblem solverAble to work various shifts and daysAdaptability to an ever-changing environmentEDUCATION and/or EXPERIENCE:High School diploma or equivalent requiredTwo (2) years’ pharmacy billing experience required (long-term care preferred)Framework LTC & General computer knowledge & 10-key Number Entry preferredKnowledge of Sage preferredPHYSICAL DEMANDSThe 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 dayThe employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walkMay be necessary to work extended hours as neededMay lift and/or move up to 30 poundsThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this roleHOLIDAY & PTO POLICYPaid 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 EmployeesMedical, Dental, and Vision insurance401 (k) (available for Part Time & Full Time EEs)Company Paid Life insuranceShort-term and Long-term disability insuranceTuition reimbursementPersonal Time Off (PTO)Competitive pay with annual performance reviews and merit-based raisesCareer growth potentialAnnual on-site voluntary Flu VaccinesEmployee referral bonus program