Job Description
Position Overview
We are seeking a detail-oriented and experienced Benefits configuration analyst to join our dynamic Business Process Services team at Wipro LLC. This role focuses primarily on claims processing within the Facets environment, working US business hours to ensure efficient and accurate benefit configuration and coding. The successful candidate will play a critical role in designing, analyzing, and implementing benefit coding changes, interfacing directly with clients and internal stakeholders to optimize benefit plans.
The role requires a minimum of three years of hands-on experience in claims processing, particularly within a healthcare BPO setting. You will collaborate with multiple teams to analyze client requirements, troubleshoot complex issues, and facilitate the seamless execution of configuration changes.
Key Responsibilities
- Design, analyze, and implement benefit codes with precision, ensuring alignment with client specifications and benefit plans.
- Act as a liaison between clients and internal partners to gather and interpret benefit requirements, presenting feasible configuration solutions.
- Manage non-standard plan design projects from coding through testing and validation, maintaining meticulous quality standards.
- Lead facilitation of team discussions to clarify client intents and program configurations.
- Resolve escalated client inquiries promptly by coordinating with cross-functional teams to identify root causes and implement effective solutions.
- Translate customer-specific requirements into detailed technical design specifications that support program development and coding.
Work Schedule and Environment
This is a non-voice, individual contributor role operating during the U.S. Eastern Time Zone business hours of 8:00 AM to 5:00 PM. You will work within a collaborative, fast-paced environment committed to delivering exceptional client service while upholding the highest compliance and quality standards.
Qualifications and Skills
- High school diploma or undergraduate degree preferred.
- Minimum of 3 years experience in claims processing within the Facets system.
- Comprehensive knowledge of benefit plan setup, configuration, and claims processing workflows.
- Strong analytical and problem-solving skills with the ability to manage complex configurations effectively.
- Excellent communication skills to articulate technical details to both clients and internal teams.
- Ability to thrive in a detail-oriented and deadline-driven setting while maintaining accuracy and productivity.
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Performance Metrics and Success Measures
| No | Performance Parameter | Measure |
|---|---|---|
| 1 | Process Efficiency and Quality | Number of cases resolved daily, adherence to process and quality standards, achieving process-level SLAs, pulse survey scores, and positive customer feedback. |
| 2 | Self-Management and Development | Individual productivity, operational efficiency, attendance record, training hours completed, and achievement in technical certification programs. |
At Wipro LLC, we prioritize collaboration, continuous improvement, and a client-centric approach, driving sustained success and professional growth for our team members. This role offers the opportunity to contribute meaningfully to our healthcare clients' processes while advancing your career within a global leader in digital transformation.
Mandatory Skills: Claims_Processing .
Experience: 1-3 Years .
The expected compensation for this role ranges from $55,000 to $60,000 .
Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. 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.
Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.
Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.
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