Medical Billing Specialist

Medical Billing Specialist

We are seeking a detail-oriented Medical Billing Specialist who takes ownership of results and delivers exceptional service. In this role, you'll support both our clients and our organization by ensuring claims are processed accurately, reimbursements are collected promptly, and accounts are managed professionally and compliantly.

Success is measured through achievement of established productivity, quality, accuracy, compliance, and customer service standards while contributing to a respectful, collaborative workplace.

This position is approved for hybrid work within Oregon. Employees must maintain a dedicated, private workspace that supports confidentiality and HIPAA compliance. They must also have reliable high-speed internet capable of supporting video conferencing and cloud-based systems, professional availability during established business hours, the ability to participate in virtual meetings, training, and collaboration activities using agency-provided technology, and residency within Oregon service area.

In this role, you will:

• Submit accurate, timely claims for commercial insurance, Medicaid, Medicare, and client-pay accounts.
• Resolve denied, unpaid, and underpaid claims to maximize reimbursement.
• Maintain clean accounts receivable and proactively reduce aging balances.
• Provide responsive, professional support to clients regarding billing and account questions.
• Consistently meet productivity, quality, compliance, and customer service expectations.
• Partner effectively with internal teams, payers, and external stakeholders to improve outcomes and processes.

Key responsibilities include:

• Billing, Claims & Reimbursement: Submit and manage billing for commercial insurance, Medicaid, Medicare, and direct-pay accounts. Investigate and resolve denied, unpaid, and underpaid claims. Process service authorizations and support timely reimbursement for approved services. Manage follow-up, collections, and denial resolution activities while meeting established performance standards.
• Accounts Receivable Management: Post payments, reconcile accounts, process refunds, prepare statements, and support month-end activity. Monitor aging reports and perform collection activities in accordance with agency policies. Communicate account status, reimbursement trends, and collection efforts as needed.
• Client Billing Support: Process financial assistance applications and verify eligibility. Respond to billing inquiries with professionalism, empathy, and accuracy. Escalate complex account issues for additional review when necessary.
• Compliance & Reporting: Maintain accurate billing, reimbursement, collections, and financial records. Ensure compliance with federal, state, payer, and agency requirements. Protect confidential client and organizational information in accordance with HIPAA and agency policies.
• Team & Organizational Contribution: Participate in meetings, training, and professional development activities. Stay current on billing regulations, reimbursement requirements, and industry changes. Contribute to process improvement initiatives that enhance efficiency, service quality, and compliance. Demonstrate professionalism, accountability, integrity, and respect in all interactions.

Preferred qualifications include:

• Two or more years of medical billing and coding experience, preferably in behavioral health, mental health, substance use disorder treatment, community mental health, or psychiatric services.
• Working knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, authorizations, and payer reimbursement requirements.
• Experience billing Oregon Medicaid behavioral health services and Medicare mental health services strongly preferred.
• Knowledge of accounts receivable management, reimbursement practices, and collections.
• Experience with electronic health record (EHR) systems and Microsoft Office applications.
• Strong written and verbal communication skills.
• Excellent organizational skills and attention to detail.
• Ability to build and maintain effective relationships with clients, coworkers, insurance representatives, and external partners.

The traits that drive success include:

• Strong billing and reimbursement expertise
• Problem-solving and analytical thinking
• Client-focused service
• Clear and professional communication
• Accountability and ownership
• Effective time management and organization
• Accuracy, quality, and compliance focus
• Collaborative, team-oriented mindset

Why join us? We believe strong financial operations support exceptional client care. You'll join a team that values collaboration, respect, accountability, and continuous improvement while doing work that directly supports access to behavioral health services.

If you're a skilled billing professional who enjoys solving problems, improving outcomes, and delivering excellent service, we'd love to hear from you.

Other considerations: Klamath Basin Behavioral Health celebrates diversity and is committed to creating inclusive and equal access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression, and veteran's status. Our employment decisions are based on qualifications, merit, and agency need.