Job Description
Remote Healthcare Customer Service Intake Call Center.
Wipro is seeking individuals with exceptional problem-solving skills and a strong customer service background. Wipro is a leading global IT solutions and services company with over 240,000 dedicated employees serving clients across multiple continents and 66 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.
As a Health Insurance Customer Service Advocate, you will work with members and health providers for Prior Auth creation and review pending statuses. This position helps to enroll our members into CMC programs such as cancer, kidney, artificial hearts, ortho etc. You will review if the member’s policy have access, review qualifications, inform what program are available for them and set up appointments with providers.
The position is remote but does require you to be available to work 8 hours per day – Monday thru Friday 7am-7pm CST.
Primary Responsibilities:
- This is a call center production role for Inbound Calls 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 occasional outbound calls to providers to coordinate provider availability in treating members
- Other duties as assigned by manager and/or director
Required Qualifications:
- High School Diploma / GED (or higher) – Will be required to provide documentation for verification
- 2+ years of combined or related experience in a healthcare adminstration with understanding of medical terminology
- 1+ year of call center experience
- Proficiency with Microsoft Office Word (create and maintain documents), Excel (create and maintain spreadsheets) and Outlook(email and calendaring)
- Should have typing speed 35+ WPM.
- Ability to follow a script for every call
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy in compliance with HIppa regulations
- Highspeed internet with 20mbps upload/download speed.
- Ability to work one of the varying shift to support our 24hr 7 days a week operations
Preferred Qualifications:
- Associate’s Degree (or higher) in a healthcare related field
- Medical Terminology
- ICD-9/ICD-10 and CPT Knowledge
Provider Inbound