Please note: This position is based at our off-site clinic located at 320 Warner Drive – Lewiston, ID and is not at the main hospital campus.

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

• The Billing Representative – CBO is responsible for managing billing procedures for accuracy, completeness, and timely processing. This role performs charge reviews, data entry, payment posting, denial resolution, and supports audits to ensure compliance with payer regulations and internal financial policies. The Billing Representative works under general supervision and collaborates with clinic operations and revenue cycle teams.

Essential Functions

• Review charges for accuracy and compliance with coding protocols and payer guidelines
• Enter and post charges using appropriate modifiers and codes
• Process payments and adjustments in the billing system accurately
• Conduct and support special request audits, patient requests, and payer/government audits
• Review daily account activity and resolve any discrepancies or incomplete records
• Apply patient payments and discounts in billing software (e.g., Athena)
• Address billing edits and denials through assigned task lists
• Audit injection/infusion charges to ensure proper hierarchy and billing accuracy
• Follow up on outstanding claims and manage denial resolution processes
• Verify and process refunds to patients and payers with appropriate documentation
• Maintain up-to-date knowledge of coding guidelines and payer regulations
• Generate reconciliation and charge integrity reports as needed
• Identify and troubleshoot billing discrepancies and resolve issues promptly
• Adhere to privacy and confidentiality policies regarding patient information
• Perform other duties as assigned

Knowledge/Skills/Abilities/Expectations

• Strong working knowledge of billing and coding principles (ICD-10, CPT, HCPCS)
• Proficient in billing software, EMR systems, and Microsoft Office applications
• Excellent attention to detail and organizational skills
• Effective communication and problem-solving abilities
• Ability to manage multiple tasks in a deadline-driven environment
• Frequent sitting and use of a computer
• Occasional standing, walking, bending, and lifting up to 20 lbs
• Manual dexterity for data entry and document handling
• Office setting within a centralized billing department
• Low to moderate noise level
• Minimal exposure to physical or environmental hazards

Education

• High school diploma or equivalent required
• Coding certification preferred

Licenses/Certifications

• None required
• Coding certification preferred or required within time frame specified by facility policy

Experience

• Experience in physician practice billing and knowledge of CPT and ICD coding preferred