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Wipro is seeking individuals who combine excellent customer service and problem-solving skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team.
Wipro is a leading global IT Solutions and Services company with over 220,000 dedicated employees serving clients across more than 65 countries.
We offer a strong compensation package that includes competitive pay and day one benefits. Wipro also offers many opportunities for career advancement within our engaging and exciting culture.
Location - Currently remote (WFH)
Work authorization - U S Citizen OR U S Green Card
Available shifts - Ability to work an eight (8) hour shift Monday-Friday between 7am-7pm; Tuesday-Saturday or Sunday-Thursday shifts may be available. Flexibility to work outside standard hours of operations due to changing business needs
Purpose of Job:
Be responsible to determine if prior authorization is required and can be decisioned, or if it requires additional clinical review. Individuals support clinicians by contacting health providers and/or members to verify authorization or referral, setup cases, and document findings. Positions in this function includes those responsible for initial triage of members, administrative intake of members and working with hospitals and the clinical team.
Position is for outbound call center with a strong background in data entry. Requires someone who is meticulous especially with document review. Healthcare claims review, medical billing or prior authorization experience preferred.
Primary Responsibilities:
This is a production role, and you will have the responsibility to meet production, quality, and regulatory expectations.
- Ensure case is set up correctly and document required information
- Review, research and determine if case can be decisioned or if it requires additional clinical review
- Demonstrate proficiency and decision making by solving complex problems using available resources (documents, medical policy, standard operating procedure, etc.)
- As needed, make outbound calls to providers and/or members to obtain information regarding a case
- As needed, make outbound calls to providers to coordinate provider availability in treating members
Required:
- Minimum of a High School Diploma / GED
- 1+ years of professional experience in an office or healthcare environment
- Prior customer service experience making outbound calls
- Proficiency in using a computer
- Experience working with Microsoft Office Products including Microsoft Outlook (ability to create, edit, save, and send emails), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets)
- Ability to trouble shoot and setup computer equipment independently
- Must have a designated work area established that is separate from other living areas and can be secured to maintain PHI or PI security in line with policies and standards
- Remote but MUST live in a location that can receive a dedicated hard-wired high-speed internet connection or leverage an existing high-speed internet service provider (ISP) (minimum speed 1.5 download mps and 1 upload mps).
Preferred:
- Previous experience working with back office medical platforms and/or authorizations systems
- Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare, and/or Medicaid Services
- Professional experience in a Clerical or Administrative support related role
- Able to quickly learn various computer systems or applications
Soft Skills:
- Strong communication skills; Written and verbal
- Excellent critical thinking and problem - solving skills
- Candidate needs to be highly organized
- Analytical, problem solving and decision-making skills; ability to exercise good judgment
- Ability to prioritize work, manage multiple tasks and work independently
Job Type: Full-time
Pay: $17.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- On-the-job training
- Paid time off
- Referral program
- Vision insurance
Shift:
- Day shift
Application Question(s):
- Do you require future sponsorship in order to keep working in the USA? Yes or No.
Education:
- High school or equivalent (Required)
Experience:
- Medical Claims: 1 year (Required)
- ICD9/10: 1 year (Required)
- Medical/Health industry: 1 year (Required)
- Work from home/remote: 1 year (Required)
Work Location: Remote
