Job Description

Position Title: Claims Analyst
Location: Tampa/Atlanta (Remote)

As a claims analyst, you will play a crucial role in ensuring accurate claims processing and member eligibility determination within the healthcare sector. This position involves handling multiple detailed tasks that demand precision, effective communication, and collaboration. It is ideal for detail-oriented individuals eager to contribute to healthcare service excellence.

Key Responsibilities:

• Review and process healthcare claims and member maintenance requests, ensuring all eligibility criteria are thoroughly verified before claims are finalized.
• Identify and resolve errors within claims applications by adhering strictly to standard operating procedures (SOPs), guaranteeing compliance and accuracy.
• Enter and document relevant data meticulously into the company’s claims management system, maintaining comprehensive records to support claim validity and audit requirements.
• Consistently meet daily production targets and quality metrics both in-office and in remote settings, demonstrating reliability and accountability.
• Collaborate effectively with team members and client partners to enhance workflow, share best practices, and address challenges proactively.
• Adapt to evolving job requirements by managing multiple assignments and prioritizing tasks to meet deadlines without compromising quality.

Educational and Experience Requirements:
At least a high school diploma or GED is required. Previous healthcare industry experience is preferred but not mandatory, as comprehensive training will be provided.

Skills & Competencies:

• Proficiency in claims processing and data management.
• Strong client-centric approach with passion for delivering timely, accurate results.
• Excellent problem-solving abilities combined with effective decision-making skills.
• Superior communication skills for clear and professional interaction with clients and team members.
• Ability to work cooperatively in a dynamic team environment, valuing diverse perspectives.
• Demonstrated learning agility to adapt quickly to changes in processes and technology.

Work Environment and Schedule:
Flexible work arrangements, as long as production and quality standards are consistently met. Collaboration with various departments is essential to ensure seamless service delivery.

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Performance Expectations and Evaluation Metrics:

Success in this role is driven by a commitment to delivering quality service while continuously enhancing skills and maintaining reliability in a fast-paced environment. Regular coaching and feedback sessions will support your growth and performance excellence.

Compensation & Benefits:

The expected hourly compensation for this position ranges from $16 to $17, commensurate with experience and skill set. Additionally, employees are eligible for Wipro’s comprehensive benefits package, which includes medical and dental insurance options, disability coverage, paid time off including sick leave, and other forms of paid and unpaid leave.

Equal Opportunity & Inclusion Commitment:

Wipro LLC is dedicated to fostering an inclusive workplace where all employees and applicants are treated with respect and dignity, regardless of race, color, religion, age, sex, national origin, disability status, veteran status, sexual orientation, gender identity or expression, or any other legally protected characteristic. Applications from candidates with diverse backgrounds, including veterans and individuals with disabilities, are strongly encouraged.

Additional Information:

Employment may be contingent upon successful completion of a post-offer drug screening, subject to state law requirements. Join us to be part of a company that champions reinvention, supports your career journey, and empowers you to make a meaningful impact in the healthcare industry.