Insurance Follow-Up & Appeal Specialist

 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.