Billing Specialist

Polaris Pharmacy Services

. Process third-party billing, claim resolution, and adjudication .

Posted 9/24/2026full-timeRemote • Florida • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in third-party billing, claim resolution, and adjudication within the long-term care sector, while ensuring compliance with government regulations such as HIPAA. Proficient in managing billing processes, conducting audits, and utilizing Framework LTC for efficient account management.

Highest-signal resume keywords

Third-Party BillingClaim ResolutionFramework LTCMicrosoft ExcelLong-Term Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Billing ManagementCensus BalancingPayor VerificationInsurance VerificationAccount AuditsData EntryAnalytical Skills10-Key Number EntryReport PreparationDual Coverage Knowledge

Soft Skills

Attention to DetailProblem SolvingAdaptabilityOrganizationCustomer Service

Tools & Technologies

Microsoft WordMicrosoft OutlookSage

Certifications & Qualifications

High School Diploma or Equivalent

Industry Keywords

FFS BillingPPS BillingMedicaid CoverageCommercial PlansLong-Term Care

About the role

Key responsibilities & impact

Process third-party billing, claim resolution, and adjudication
Manage FFS and PPS billing
Conduct census balancing and payor verification
Verify insurance and Medicaid coverage
Apply knowledge of Dual Coverage, MCR D, and Commercial Plans pertaining to Long Term Care
Assist with 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 end-of-month summaries
Understand and work with residents on account balances
Follow all applicable government regulations, including HIPAA
Perform other duties as deemed necessary by the Billing Manager

Requirements

What you’ll need

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 and 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
High School diploma or equivalent required
Two (2) years’ pharmacy billing experience required; long-term care preferred
Framework LTC and general computer knowledge and 10-key number entry preferred
Knowledge of Sage preferred
May sit or stand seven (7) to ten (10) hours per day
May be necessary to work extended hours as needed
May lift and/or move up to 30 pounds

Benefits

Comp & perks

Paid holidays: 6 days annually
5 sick days annually
Up to 10 PTO days annually with rollover options and milestone bonuses
Option to cash out up to 10 PTO hours each quarter
Medical, Dental, and Vision insurance
401(k) available for part-time and full-time employees
Company-paid life insurance
Short-term and long-term disability insurance
Tuition reimbursement
Competitive pay with annual performance reviews and merit-based raises
Career growth potential
Annual on-site voluntary flu vaccines
Employee referral bonus program