Job Description
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.