FT, 80 hrs/pp, 1.0 FTE; (3 positions), varies as scheduled
Job Summary:
The Insurance Follow-Up & Appeals Specialist is responsible for the timely and
accurate resolution of unpaid, underpaid, and denied insurance claims. This role
focuses on proactive payer follow-up, denial analysis, and appeal submission to
ensure appropriate reimbursement in compliance with payer contracts,
Medicare/Medicaid regulations, and organizational policies. The specialist
serves as a subject-matter resource for complex payer issues and supports
revenue integrity through detailed documentation, trend analysis, and
collaboration with internal teams.
Required: High School Graduate or GED. Minimum 1 year of insurance follow-up,
denial management, or appeals experience in a healthcare revenue cycle setting.
Working knowledge of medical billing, insurance benefits, and EOB
interpretation. Experience with Medicare, Medicaid, and commercial payers
preferred. Strong analytical, organizational, and problem-solving skills.
Ability to communicate professionally and effectively, both verbally and in
writing.
Preferred: Experience in a Critical Access Hospital (CAH) or rural health
setting. Familiarity with Epic or similar hospital billing systems. Knowledge of
CPT, HCPCS, ICD-10, and basic payer contract concepts. Prior experience
preparing medical necessity or technical appeals.
Compensation & Benefits
* Pay Range: $22.25-$32.25
* Excellent health, dental, and vision benefits
* Retirement plan with employer contributions
* Generous paid time off
Why Prosser?
Prosser Memorial Health is proud to be the ONLY Critical Access Hospital in
Washington State with a 5-Star CMS rating and ranked among the Top 10
Recommended Hospitals in Washington.
Community Highlights:
* Friendly, welcoming community at the heart of Washington wine country
* 300 days of sunshine with easy access to the Yakima River and outdoor
recreation
* Just 30 minutes from the Tri-Cities (Pasco, Kennewick, Richland) and the
Tri-Cities Airport (PSC)
* Cost of living 18% lower than the national average
* Quick 30-minute flights to Seattle, WA, or Portland, OR
* National recognition:
* #1 Best Suburbs to Buy a House in WA (Niche)
* #1 Best Places to Live in WA (AreaVibes)
* #1 Most Secure Mid-Sized City in the U.S.
Join Our Team!
At Prosser Memorial Health, you’ll find more than just a job—you’ll find a
community and a mission. Whether you’re an experienced professional or a new
graduate, this is an opportunity to grow your career in a supportive
environment, with state-of-the-art facilities and an outstanding team.