Job Description

We are seeking an experienced and dedicated Wellness Coordinator to join our team at Wipro LLC. In this role, you will be the first point of contact for healthcare providers and members, efficiently managing queue-based incoming calls. Your primary responsibility will be to identify the specific assistance required, such as benefits and eligibility inquiries, authorization for treatments, provider referrals, and resource identification. You will play a crucial role in gathering clinical information that licensed staff utilize to make informed decisions aligned with clinical policies.

This position requires a professional with a minimum of a High School Diploma or GED and at least two years of experience in healthcare, complemented by two years of call center experience and at least one year of working remotely. A reliable internet connection with a minimum speed of 30 Mbps for both download and upload is necessary to ensure seamless communication and data handling.

Preferred candidates will have experience working within medical or behavioral health settings such as hospitals, managed care organizations, or joint medical/behavioral outpatient practices. Familiarity with coordinating multiple benefit groups and leveraging various patient resources, as well as a working knowledge of community-based resources and services, would be highly beneficial.

Key Responsibilities:

• Resolve queries on the first call by expertly navigating complex computer systems to ascertain request statuses and provide accurate information.
• Communicate confidently to facilitate positive outcomes with healthcare providers and members, maintaining professionalism in all interactions.
• Document all call interactions thoroughly and simultaneously, ensuring accuracy in real-time.
• Act as a Subject Matter Expert or resource person for team members and internal clients, supporting their information needs effectively.
• Initiate outbound calls to families with children diagnosed with Autism to discuss provider referrals and behavioral health requirements.
• Collect data from providers and input information accurately across multiple documentation systems.
• Engage with providers to clarify information related to benefits and authorizations, assisting with comprehensive care coordination.
• Coordinate and provide clinical information to relevant clinical team members.
• Perform triage for submission of clinical information, establish cases to ensure timely review, and complete administrative follow-ups as necessary.

This role offers an opportunity to be part of a supportive, innovative environment focused on delivering outstanding service and improving health outcomes. If you thrive in a dynamic setting, have a passion for healthcare coordination, and enjoy assisting both providers and members, we encourage you to apply.

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Performance Delivery Expectations

These performance parameters are designed to support your growth and success within the organization, providing clear expectations and feedback mechanisms. We place a high value on continuous improvement, proactive communication, and collaborative problem-solving to uphold our commitment to excellence in service delivery.