Job Description

The Direct Dropout Claim Specialist is a crucial contributor to the claims processing team within Wipro LLC, operating in the BPS-HLS P&P sector. This role centers on the rigorous assessment and validation of dropout claim submissions to ensure they meet predefined eligibility criteria. The Specialist is responsible for upholding the highest standards in accuracy and compliance while supporting efficient claim resolutions.

Working in a dynamic team-oriented environment, you will balance analytical evaluation with effective communication skills, facilitating smooth interactions between claimants, clients, and internal departments. This role demands the application of informed judgment within established policies, ensuring timely and accurate claim outcomes that enhance client trust and satisfaction.

Moreover, your responsibilities extend to analyzing claim trends and generating meaningful reports that assist in strategic decision-making and continuous operational improvements. By maintaining a strong commitment to detail and quality, you will play a significant role in advancing Wipro’s reputation for exceptional service delivery in claims processing.

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Key Responsibilities Include:

• Collaborate closely with client partners and cross-functional teams to process and validate claim applications efficiently.
• Conduct eligibility assessments and perform member maintenance activities, ensuring all changes adhere strictly to company policies and regulatory requirements.
• Accurately document all relevant claim information into specialized systems, maintaining up-to-date records and audit readiness.
• Consistently meet or exceed production targets, quality benchmarks, and service level agreements, whether working onsite or remotely.
• Execute multiple concurrent tasks within your scope, demonstrating adaptability and effective time management.
• Maintain exemplary organizational skills, focusing on precision and attention to detail to prevent errors and enhance processing accuracy.
• Exercise independent decision-making abilities while aligning with corporate standards and guidelines.
• Demonstrate a proactive and motivated approach to exceed both personal and team objectives.
• Adhere to professional communication standards across email, chat, and other correspondence, reflecting a courteous and energetic demeanor.
• Commit to mandatory overtime when required, ensuring operational continuity.
• Observe consistent attendance, especially during the initial 90-day period, to support onboarding and performance consistency.
• Comply with dress code standards during in-office training and system setup phases.

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• A High School Diploma or GED is mandatory and will be verified as part of the hiring process.
• Preferably, candidates will have at least one year of professional experience, ideally in claims processing, data entry, or customer service environments.
• Proficiency in backend processing and familiarity with claims-related workflows strongly preferred but not required.
• Exceptional reading comprehension, analytical, and problem-solving skills are essential to succeed in this role.
• Must demonstrate solid computer literacy, including a basic understanding of hardware connectivity such as USB interfaces.
• Strong communication skills, both verbal and written, with the ability to convey information clearly and professionally.
• A minimum typing speed of 30 words per minute with 90% accuracy is required to ensure efficiency in data entry tasks.
• Applicants must be able to provide documentation requested for comprehensive background checks.
• Possession of foundational knowledge related to claims processing business operations and relevant platform systems is advantageous.