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Title:  Health Insurance Customer Service Agent

Requisition ID:  71098
City:  Atlanta
Country/Region:  US
Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients’ most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world. For additional information, visit us at www.wipro.com.

Job Description

We are continuing to grow! Come grow with us!!!

Wipro is seeking customer service/claims processors who combine excellent coordination and authorization 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

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Primary Responsibilities:

  • Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission
    Providing excellent customer service, including the ability to handle escalated callers
    Determining authorization or notification requirements
    Preparing authorization cases for Medical Directors, Network Operations Nurses and Case Managers
    Providing administrative approvals (depends on line of business)
    Handling expedited authorizations, authorization updates and status checks
    Confirming member eligibility
    Outreaches to providers and/or Patient to complete authorization requests and prescriptions
    Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
    Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
    Non-Clinical staff is not responsible for conducting any Network Operations activity that requires interpretation of clinical information.
    Performs all other related duties as assigned.

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  • Deliver excellent customer service through effective diagnosis and troubleshooting of client queries
    • Provide product support and resolution to clients by performing a question diagnosis while guiding users through step-by-step solutions
    • Assist clients with navigating around product menus and facilitate better understanding of product features 
    • Troubleshoot all client queries in a user-friendly, courteous and professional manner
    • Maintain logs and records of all customer queries as per the standard procedures and guidelines
    • Accurately process and record all incoming call and email using the designated tracking software
    • Offer alternative solutions to clients (where appropriate) with the objective of retaining customers’ and clients’ business
    • Organize ideas and effectively communicate oral messages appropriate to listeners and situations
    • Follow up and make scheduled call backs to customers to record feedback and ensure compliance to contract /SLAs

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  • Build capability to ensure operational excellence and maintain superior customer service levels of the existing account/client
    • Undertake product trainings to stay current with product features, changes and updates
    • Enroll in product specific and any other trainings per client requirements/recommendations
    • Partner with team leaders to brainstorm and identify training themes and learning issues to better serve the client
    • Update job knowledge by participating in self learning opportunities and maintaining personal networks

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Deliver

No Performance Parameter Measure
1 Process No. of cases resolved per day, compliance to process and quality standards, meeting process level SLAs, Pulse score, Customer feedback
2 Self- Management Productivity, efficiency, absenteeism, Training Hours, No of technical training completed

 

Mandatory Skills: Claims_Processing .

 

Expected annual pay for this role ranges from $25,000 to $50,000 . Based on the position, the role is also eligible for Wipro’s standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.

 

Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention. Come to Wipro. Realize your ambitions. Applications from people with disabilities are explicitly welcome.

If you encounter any suspicious mail, advertisements, or persons who offer jobs at Wipro, please email us at helpdesk.recruitment@wipro.com. Do not email your resume to this ID as it is not monitored for resumes and career applications.

Any complaints or concerns regarding unethical/unfair hiring practices should be directed to our Ombuds Group at ombuds.person@wipro.com.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, caste, creed, religion, gender, marital status, age, ethnic and national origin, gender identity, gender expression, sexual orientation, political orientation, disability status, protected veteran status, or any other characteristic protected by law.

Wipro is committed to creating an accessible, supportive, and inclusive workplace. Reasonable accommodation will be provided to all applicants including persons with disabilities, throughout the recruitment and selection process. Accommodations must be communicated in advance of the application, where possible, and will be reviewed on an individual basis. Wipro provides equal opportunities to all and values diversity.


Nearest Major Market: Corning

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