Pharmacy Billing Specialist: Claims & Benefits Expert

Klamath-Tribal-Health-; Klamath Falls (OR); On-site; USD 40,000 - 71,000; Full time

Job summary

Klamath Tribal Health & Family Services in Klamath Falls, OR is seeking a Pharmacy Billing Specialist. The role supports billing of prescriptions and services under the Pharmacy Billing Office, working under the Pharmacy Billing Manager.

Required qualifications include a high school diploma or equivalent, Oregon Pharmacy Technician Licensure, and CPhT certification, with extensive experience in pharmacy billing and HIPAA compliance. The position is full-time and on-site at KTHFS.

Qualifications

• High School Diploma or Equivalent is required.
• Oregon Pharmacy Technician Licensure is required.
• Pharmacy Technician Certification (CPhT) is required.
• At least ten (10) years as a Nationally Certified Pharmacy Technician.
• Knowledge of Medicare/Medicaid billing and HIPAA.
• Strong computer skills and word processing.

Responsibilities

• Maintain knowledge of pharmacy claims review and billing processes.
• Collaborate with pharmacy staff to respond to billing questions.
• Post pharmacy payments accurately and timely.
• Reconcile pharmacy claims and reduce denials.
• Assist with pharmacy audits and prior authorizations as needed.

Skills

Pharmacy billing

HIPAA privacy

Microsoft Office

Communication

Education

High School Diploma or Equivalent

Oregon Pharmacy Technician Licensure

Pharmacy Technician Certification (CPhT)

Tools

Billing software

Job description

Klamath Tribal Health & Family Services in Klamath Falls, OR is seeking a Pharmacy Billing Specialist. The role supports billing of prescriptions and services under the Pharmacy Billing Office, working under the Pharmacy Billing Manager.

Required qualifications include a high school diploma or equivalent, Oregon Pharmacy Technician Licensure, and CPhT certification, with extensive experience in pharmacy billing and HIPAA compliance. The position is full-time and on-site at KTHFS.