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 c omplex 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
Qualifications:
Preferred Experience:
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.