Title: Back Office- Claims Processor (Remote)
Job Description
Wipro is searching for qualified candidates for a remote, health insurance claims processing position. This is a back-office, data processing position focused on family support insurance claims that will include investigations, negotiating settlements, payments and research regarding eligibility.
Excellent understanding of computer systems especially with Excel, Word, Outlook and Teams is required. Previous experience with claims processing and medical terminology required.
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Primary duties may include, but are not limited to:
- -Research, identify and obtain data/information needed to help process claims or resolve claims issues (e.g., verify pricing, prior authorizations, applicable benefits)
- -Ensure that proper benefits are applied to every claim
- -Apply knowledge of customer service requirements to process claims appropriately
-Identify and apply knowledge of new plans/customers to process their claims appropriately - -Identify and resolve claims processing errors/issues and trends, as needed
- -Resolve or address new or unusual claims errors/issues as they arise
- -Communicate and collaborate with external stakeholders to resolve claims
- -Collaborate with internal business partners to resolve claims errors/issues
- -Document and communicate status of claims/investigations as needed
- -Achieve applicable performance metrics
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Required Qualifications
- HS Diploma or Equivalent - You will need to provide education document for verification
- Medicare knowledge preferred.
- 1+ Years of healthcare/ insurance experience.
- 1+ years WFH.
- Typing speed - 40+ wmp.
- At home internet speeds 20+ MBPS (up & down)
- No planned leaves/Vacation for first 90 days
- Able to commute and attend all in office training.
The Claims Analyst position responsible for processing medical, dental and vision claims.
Back Office- Claims Processor (Remote)
Wipro is searching for qualified candidates for health insurance claims processing.
This position will be in the family support claim processing that will include investigations, negotiating settlements, payments and research regarding eligibility.
Primary duties may include, but are not limited to:
· -Research, identify and obtain data/information needed to help process claims or resolve claims issues (e.g., verify pricing, prior authorizations, applicable benefits)
· -Ensure that proper benefits are applied to every claim
· -Apply knowledge of customer service requirements to process claims appropriately -Identify and apply knowledge of new plans/customers to process their claims appropriately
· -Identify and resolve claims processing errors/issues and trends, as needed
· -Resolve or address new or unusual claims errors/issues as they arise
· -Communicate and collaborate with external stakeholders to resolve claims
· -Collaborate with internal business partners to resolve claims errors/issues
· -Document and communicate status of claims/investigations as needed
· -Achieve applicable performance metrics
Required Qualifications
· HS Diploma or Equivalent
· Medicare knowledge preferred.
· 1+ Years of healthcare/ insurance experience.
· 1+ years WFH.
· Typing speed - 40+ wmp.
· At home internet speeds 20+ MBPS (up & down)
· No planned leaves/Vacation for first 90 days
KPI – Key performance indicators, Call metrics, Adherence metrics, Average call time.
Nearest Major Market: Kansas City