Revenue Recovery Specialist: Denials & Appeals

American Addiction Centers; Worcester (MA); Hybrid; USD 35,000 - 48,000; Full time

Benefits offered by this job

401K matching

Medical insurance

Dental insurance

Vision insurance

Life insurance

Job summary

American Addiction Centers in Worcester, MA is seeking a Denials & Appeals Specialist to investigate, resolve, and appeal denied insurance claims from third-party payers. You will analyze unpaid/denied claims, identify denial causes, and develop resolution strategies to recover revenue.

The role requires strong medical coding knowledge (ICD-10-CM, CPT), experience with EHRs, and excellent written and verbal communication.

Qualifications

• Education: High School Diploma or GED; an Associate or Bachelor’s in Healthcare Administration preferred.
• Experience: 2–4 years in healthcare billing, medical collections, or AR with denial management focus.
• Certifications: CPC or CRCR preferred but not required.
• Technical: ICD-10-CM, CPT, UB-04/CMS-1500 familiarity.

Responsibilities

• Review and analyze insurance claim denials with EHRs and EOB/RA.
• Identify denial reasons such as medical necessity or coding errors.
• Prepare and submit formal appeals with supporting docs.
• Collaborate with coding, billing, and clinical teams to resolve issues.
• Track and report denial trends and appeal outcomes.

Skills

Medical coding

Denials management

Analytical skills

Communication

Attention to detail

Education

High School Diploma or GED

Healthcare Admin degree preferred

Tools

Epic

NextGen

eClinicalWorks

Availity

Job description

American Addiction Centers in Worcester, MA is seeking a Denials & Appeals Specialist to investigate, resolve, and appeal denied insurance claims from third-party payers. You will analyze unpaid/denied claims, identify denial causes, and develop resolution strategies to recover revenue.

The role requires strong medical coding knowledge (ICD-10-CM, CPT), experience with EHRs, and excellent written and verbal communication.