ar support representative ( Work From Home)AJT Diabetic Inc.

About Us:
AJT Diabetic Incorporated, doing business as Countrywide Medical, is a leading Medicare-contracted supplier that provides high-quality medical supplies and durable medical equipment to our valued patients. We are dedicated to providing the best care and service for our patients' medical supply and equipment needs.
Our team of caring professionals are committed to ensuring our patients' medical needs are always taken care of. We are B.O.C Accredited and comply with all state licensure requirements to provide home medical equipment and supplies, delivered across all 50 US States. We supply patients in need of all major medical equipment and supplies, including Diabetic Testing Supplies and Continuous Glucose Supplies, CPAP supplies, urological supplies, wound care supplies, nebulizers and equipment, oxygen, and much more.
We are quickly expanding and urgently looking for several highly skilled, self-motivated, and experienced individuals to join AR Team. The job is a full-time permanent work-from-home position on US Eastern Time Zone Hours. This is not a part time position.
IMPORTANT NOTICE: We work directly with employees and are not affiliated with any recruitment agencies, training centers, or call center/BPO companies. You must be independent, and non-affiliated with any call center, training center or other BPO companies.
To be considered for this great opportunity, please submit your resume, outlining the name of your current and/or prior employer, work title, dates worked, and duties and responsibilities.
INTERNET & HARDWARE REQUIREMENTS
MUST have 2 monitors.
MUST have backup internet. (prepaid will do)
8 GB of system memory.
i3 processor or higher.
Fiber or highspeed internet of at least 20MBPs. (both upload & download)
Windows 10 or 11, MacOS Sierra or higher, or ChromeOS with Google Chrome Web Browser Installed
Wired headset.
Malware and virus-free/protected computer.
Skype account.
Valid government-issued ID/driver's license.
Job Requirement:
Review charts and claims for accuracy
Minimal 2 years of experience in a medical-AR related background
Must have work experience with US medical insurance companies such as Medicare, Medicaid, and Commercials (United Health Group, WellCare, Anthem (Blue Cross, Blue Shield), Humana, Medicaid, Kaiser Permanente, etc.)
Familiar with different insurance web portals such as Availity, CCX, UHC, Navinet, etc.
Experience in logging, tracking, and processing appeals.
Be able to conduct pertinent research in order to evaluate, respond to, and close appeals.
Assure timeliness and appropriateness of all Provider appeals accordingly.
With experience working with claims insurance process follow-ups and different types of denials.
With experience handling correction of claims and resubmission.
Can read and understand the explanation of benefits and how to identify incorrect denial.
Knowledge of common medical coding and guidelines.
Must have excellent time management skills and be able to handle multiple tasks effectively and efficiently.
Excellent verbal and written communication skills
Knowledge of Microsoft, Excel, and Outlook email.
Communicate effectively to hand-off or pick-up work from colleagues
Perform other duties assigned by Team Lead or Manager
Scope of Support:
Calling the doctor's office to obtain medical documentation
Review and prepare all documents for appeal processing. Documents are processed via: fax, email, mail, and portal.
Calling insurance to follow up if medical records were received and being processed.
Calling insurance to follow up on appeal decision if the final response has not been received timely.
Amenable to finish a minimum of 40 claims at minimum daily with no activity lapses.