Insurance Specialist / Full-Time

HRJobPosting: Rev 12/2024

INSURANCE SPECIALIST
Full-Time

Posting Number: HR074118 Posting Date: March 24, 2025 Date Available: Immediately
Position Summary: The Insurance Specialist will process accurate and timely billing to insurance carriers and to ensure correct

payment is received from them in a timely fashion.
Essential Job Duties: Works assigned work queues in CPSI system on a daily basis. Processes secondary or tertiary claims as needed by

accurately attaching the appropriate primary EOB prior to submission. Accurately appends insurance information
on coverage records in revenue cycle system within 24 hours of receipt. When necessary, verifies information via
various electronic means. Maintains work queues generated by electronic submission of claims, correcting errors
and reprocessing claims as needed. Via work queues and receipt of correspondence from insurance carriers,
provides follow-up of unpaid (or incorrectly paid) claims as dictated by department policy. Submits corrected
claims as needed and processes appeals for incorrectly denied claims. (Processes write-offs as needed and as
dictated by department policy). When available, processes on-line adjustments to insurance claims. Complies with
audit requests by insurance carriers in a timely fashion. When necessary, reviews medical records and resubmits
claims with appropriate documentation to expedite claims processing (adhering to confidentiality requirements).
Accurately processes corrections on accounts with each action taken and each contact made. Responsible to keep
up to date with current insurance billing requirements and changes by reading payer newsletters, reviewing
websites and other publications. Participates in payer meetings, developing relations with payer representatives
and assisting with troubleshooting and problem-solving processes. Actively participates in departmental; and/or
organizational process improvement initiatives. Assists in other areas of the department (payments or coding) as
needed. Assists providers and staff in other departments with insurance and billing inquires in a friendly and
professional manner while on the phone or corresponding through mail. Assists in maintaining a neat and
professional workplace. Works on special projects related to A/R clean up as requested by department leadership.
Other duties as assigned.

Qualifications: High School diploma or GED. Previous experience in health care billing, medical terminology, ICD-9/10 and CPT
coding highly desired. Graduation from a recognized medical billing program desirable. Two years prior experience
in a hospital business office preferred. Insurance billing and follow up experience will substitute for collection
experience. Medical billing terminology and knowledge of insurance payer’s desirable. Good communication skills,
both oral and written.

Position Wage Range: MIN: $19.93 MAX: $27.48 Low-Census: $4.00/hour
Schedule: Days: Monday – Friday Hours: 8:00am – 4:30pm; 8-hour shifts

Department/FTE: Patient Accounts FTE: 1.00 - 40 hours/week Benefit eligible? Yes
Benefit Summary: Benefits include Group Medical (employee’s premium is paid by the hospital); voluntary plans for Dental & Vision offered.

Dependent coverage is also available. Employer paid basic plans for Life, Long-Term Disability, & Short-Term Disability with buyup
options available. Voluntary Life with guaranteed issue. A Flexible Spending Account (FSA) plan is offered. A complimentary 24/7
Employee Assistance Program (EAP) for all staff is available. Insurance benefits are effective the first of the month following
hire date.

Physical Requirements: Please see full Job Description in Human Resources

INTERESTED CANDIDATES – PLEASE APPLY HR USE ONLY
MAIL OR APPLY IN-PERSON: Three Rivers Hospital

Human Resources Department
PO Box 577
507 Hospital Way
Brewster, WA 98812
(509) 689-2517

APPLY ONLINE: www.threerivershospital.net
HR CONTACT EMAIL: opportunity@trhospital.net

Three Rivers Hospital is an equal opportunity employer.