Pharmacy Billing & Reimbursement Specialist

Indian Health Service; Klamath Falls (OR); On-site; USD 55,000 - 75,000; Full time

Job summary

Klamath Tribal Health & Family Services seeks an experienced Pharmacy Billing Specialist to support accurate claims processing, prior authorizations, and timely reconciliation of payments. You will work under Pharmacy Billing Manager supervision to uphold billing accuracy and compliant procedures within the tribal health system.

The role requires extensive national certification for pharmacy technicians, Oregon licensure, and a strong background in fraud prevention and healthcare compliance.

Qualifications

• High School Diploma or Equivalent required.
• Must hold Oregon Pharmacy Technician Licensure.
• Pharmacy Technician Certification (CPhT) required.
• At least ten years as Nationally Certified Pharmacy Technician.
• Background check and adherence to health policies required.

Responsibilities

• Review and audit pharmacy claims and billing for accuracy.
• Support pharmacy staff with billing questions and needs.
• Maintain accurate demographic and billing information.
• Submit prior authorizations and reconcile payments timely.
• Assist with pharmacy audits and fraud, waste and abuse training.

Skills

Computer skills

Records management

Fraud, waste and abuse awareness

Education

High School Diploma or Equivalent

Certified Oregon Pharmacy Technician Licensure

Pharmacy Technician Certification (CPhT)

Job description

Klamath Tribal Health & Family Services seeks an experienced Pharmacy Billing Specialist to support accurate claims processing, prior authorizations, and timely reconciliation of payments. You will work under Pharmacy Billing Manager supervision to uphold billing accuracy and compliant procedures within the tribal health system.

The role requires extensive national certification for pharmacy technicians, Oregon licensure, and a strong background in fraud prevention and healthcare compliance.