Billing Specialist

Job Summary The Billing Specialist is responsible for Nursing Homes, Assisted Living Facilities, Group Homes, and Private Pay statements. Duties and 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 Required Skills and 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 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 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 Holiday and 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. 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 #J-18808-Ljbffr Polaris Pharmacy Services