Billing Specialist II

Locations: Klamath Falls, OR

Type:Tribal

Salary Range:$39,445 to $69,167 / Per Year

Open Period:1/15/2026 until filled

Summary:APPLICATION PROCEDURE Submit a Klamath Tribal Health & Family Services Application for Employment with all requirements and supporting documentation to: Klamath Tribal Health & Family Services ATTN: Human Resource 3949 South 6th Street Klamath Falls, OR 97603 ... IT IS THE RESPONSIBILITY OF THE APPLICANT TO PROVIDE SUFFICIENT INFORMATION TO PROVE QUALIFICATIONS FOR TRIBAL POSITIONS. Please Note: If requirements are not met, i.e., submission of a resume in lieu of a tribal application or not including a required certification, your application will not be reviewed and will be disqualified. Indian Preference will apply. In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for "Indian Preference". Applications will not be returned.

More info about area:

Job Announcement Flyer:

Duties:1. Daily review, analyze, and interpret patient ambulatory EHR and/or paper encounter coding and corresponding chart note documentation and determine that the appropriate diagnostic and procedural codes are used and appropriately reflected in the chart note for code assignment as outlined by the CMS guidelines. Assuring that medical/dental necessity billing guidelines are met. 2. Ensure the appropriate service codes are applied in the billing record that corresponds to the documentation referenced in the chart note or on the encounter forms. Ensure that the appropriate ICD-10, CPT, HCPCS, CDT coding conventions have been used for services provided by all health service types within KTHFS, including but not limited to: medical, dental, behavioral health and transportation. 3. Work with providers and nursing staff to clarify documentation in the EHR system if needed. Including correlating anatomical and physiological processes of a diagnosis to assure the most accurate ICD-10 code(s) are used. Advise supervisor and clinicians of deficiencies to support charge capture of all billable services. 4. Prepare and submit clean claims (electronic or paper) to primary/secondary insurance carriers including Medicaid, Medicare, (Part A&B), and private insurance companies. 5. Maintain compliance with billing regulations: including Medicaid (DMAP), Medicare (Parts A&B, DME), Private Insurance Carriers (i.e. HMA, BCBS, ODS, etc.). 6. Payment post insurance checks or EFTs, which includes: verifying the checks or EFTs that have been receipted in the KTHFS Operations Support System, batching the checks or EFTs into the current billing system, and then accurately posting the payments into the current billing system. 7. Process refunds for any overpayments made to KTHFS. Monitor claims payment and promptly request POs for refunds to insurance companies, or perform electronic claim adjustments per payer requirements, for any overpayments made on claims. The refund will also be processed to reflect the claim refund in the practice management system. (refer to the job announcement pdf for the listing of additional duties)

Qualifications:Minimum Qualifications: Failure to comply with minimum position requirements may result in termination of employment. REQUIRED to possess a High School Diploma or Equivalent. (Must submit copy of diploma or transcripts with application.) REQUIRED Must have one of the following certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Medical Coder (RMC), RHIA, RHIT or an Associate's degree in Medical Office Systems or Health Information Management. REQUIRED One (1) year of medical and/or dental billing and coding experience. Experience must be reflected on application; or submit copy of coder certification with application REQUIRED Demonstrated proficiency in the technical knowledge of medical terminology, anatomy and physiology, and CPT and ICD-10-CM coding systems REQUIRED to have Computer and/or word processor experience. REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime. REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers. REQUIRED to accept the responsibility of a mandatory reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Resolution #2005 003, all Tribal staff are considered mandatory reporters. Job Description: Billing Specialist Page 6 of 6 Revised: 4/17/2023 AAPC coder certified or AHIMA coder certified. Experience with NextGen or other electronic health record system is preferred. Indian Preference: Indian Preference will apply as per policy. Must submit documentation with application to qualify for Indian Preference.

Work Type:Permanent, Full

Announcement #:KTHFS-2026-BS2