Revenue Cycle Appeals & Recovery Specialist

American Vascular Associates (AVA) is a physician practice management company in a high-growth mode. We handle medical billing for our clinical partners in multiple US States and we are currently looking to add a Revenue Cycle Appeals & Recovery Specialist to join our fast-paced and energetic team. The ideal candidate will be self-motivated, detail-oriented, and skilled in patient-centered communication. If you're looking to join a collaborative, fun, and professional environment, apply today!

This role is full time, remote with a base rate of $24 to $25 per hour and a full benefit package that includes PTO, Med/Dent/Vision coverage, 401k w/corp. matching. NO weekends or major holiday shifts. The ideal candidate will live in the Eastern or Central Time Zone of the US. 

This position will handle complex appeals & denial resolution and manage high-dollar claims.

What we want to see from you:

• Advanced expertise in writing first-level, second-level, and external review appeals
• Ability to develop compelling, evidence-based appeal narratives
• Experience overturning medical necessity denials, authorization denials, bundling edits, and coding-related denials
• Strong ability to interpret payer policies, EOBs, remittance advice, contracts, and clinical documentation.
• Ability to interpret EOBs, remittance advice, payer policies, and clinical documentation
• Proven track record of successful appeal overturn rates

• Experience working high-balance claims (e.g., $25K+, $50K+, $100K+ claims)
• Ability to prioritize and manage complex accounts with significant financial impact
• Experience escalating payer issues through executive, provider relations, or legal channels when necessary
• Strong root-cause analysis skills to identify recurring denial trends impacting large-dollar claims
• Ability to communicate effectively and professionally with physicians, clinical staff, executive leadership, and payer representatives.
• Extremely self-motivated with a strong sense of ownership and accountability.
• Proven ability to work independently with minimal supervision while maintaining high productivity and accuracy.
• Resourceful problem-solver who proactively identifies barriers and develops solutions.
• Able to manage a remote or hybrid workload effectively while consistently meeting performance expectations.
• Demonstrates initiative, persistence, and follow-through on complex claims and appeals.
• Understanding of medical terminology, diagnoses, procedures, and documentation requirements
• Familiarity with ICD-10, CPT, and HCPCS coding concepts
• Knowledge of CMS regulations and payer compliance requirements
• Ability to review clinical records and connect documentation to appeal arguments

Multi-Client & Multi-Platform Management

• Ability to successfully manage AR for multiple clients, practices, specialties, and payer types simultaneously.
• Experience working across multiple EMR, PM, billing, clearinghouse, and payer portal platforms.
• Able to quickly learn new software systems and adapt to varying client workflows and processes.
• Strong organizational skills with the ability to prioritize competing deadlines and high-volume workloads.
• Ability to analyze complex accounts and develop strategic recovery plans.

Qualifications:

• High School Diploma/GED required; Associate degree preferred
• Minimum 3 years of experience in:
  • Medical insurance billing and claims processing
  • Medical accounts receivable
• Strong understanding of EOBs/ERAs from all payers
• Proficiency in medical billing software, clearinghouse systems, and Microsoft Excel
• Excellent written and verbal communication skills
• Ability to identify and resolve issues independently

Preferred Experience:

• eClinicalWorks (eCW)
• ASC, Podiatry, or Pain Management specialty billing

Equal Opportunity Employer Statement:

American Vascular Associates is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status.