Job Description

Job Overview:
As a Wellness Coordinator at Wipro LLC, you will play a crucial role in supporting health care providers and members by managing incoming calls through a queue-based system. The position requires expertly identifying the nature of assistance needed, including benefits inquiries, eligibility checks, authorization processes, and provider referrals. Additionally, you will collect essential clinical information that enables licensed clinical staff to make informed care decisions pursuant to established clinical policies.

This role demands exceptional communication skills, proficiency with multiple complex information systems, and a commitment to delivering accurate and timely information. You will be an essential link in the continuum of care, facilitating seamless coordination between members, providers, and clinical teams. Your efforts contribute directly to improving member satisfaction and healthcare outcomes.

Key highlights of the role include:

• Handling complex inquiries with a focus on one-call resolution
• Navigating multiple data and documentation platforms to retrieve and input necessary information
• Engaging with families, especially those with members diagnosed with Autism, to explain provider referrals and behavioral health support options
• Supporting clinical teams with accurate data collection and case management activities
• Participating as a resource and subject matter expert for your teammates

Wipro is seeking a dependable and detail-oriented individual capable of working independently from a home-based environment, maintaining a professional, solution-driven approach under high-pressure call volume conditions. The role is part of the Business Process Services in the Healthcare and Life Sciences sector, emphasizing both technical proficiency and empathetic customer engagement.

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Primary Responsibilities:

• One-Call Resolution Excellence: Effectively manage inbound calls to address member and provider needs quickly and comprehensively, using multiple complex internal systems to navigate benefits, authorizations, and referrals.
• Accurate and Real-Time Documentation: Maintain meticulous records of all call interactions, simultaneously communicating verbally and documenting details to ensure data integrity and audit readiness.
• Subject Matter Expertise and Team Collaboration: Act as a go-to team member by sharing knowledge and troubleshooting challenges for peers and internal stakeholders to improve service quality.
• Outreach and Family Coordination: Initiate outbound communications to families of children diagnosed with Autism spectrum disorders, providing vital information about behavioral health services and facilitating referral processes.
• Data Collection and Coordination: Gather clinical and administrative data from providers and input it accurately into multiple documentation platforms, ensuring clinical workflows and authorizations are handled efficiently.
• Provider Liaison and Care Coordination: Clarify benefits and authorization details with providers, coordinate with teams for clinical case reviews, and track case progress to support timely outcomes.
• Administrative Case Management Support: Manage submission and triaging of clinical information, establish and organize cases for review, and conduct necessary administrative follow-ups to ensure continuity of care processes.

This multifaceted role calls for strong multitasking, critical thinking, and interpersonal skills. You will thrive in an environment that values accuracy, empathy, and proactive problem-solving, working with diverse teams across the healthcare continuum.

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Required Qualifications:

• Completion of High School Diploma or GED; additional education or training is an asset.
• A minimum of 2 years’ experience working in healthcare settings, demonstrating understanding of healthcare operations and terminology.
• At least 2 years of experience in a call center environment, maintaining high standards of customer service amid fast-paced workflows.
• Minimum of 1 year working remotely from home, with proven ability to stay organized, self-motivated, and technologically proficient.
• Reliable high-speed internet connection with a download and upload speed of at least 30 Mbps to support communication systems and digital tools.

Preferred Qualifications:

• Previous experience in medical or behavioral health settings such as hospitals, managed care organizations, or joint outpatient practices involving both medical and behavioral health services.
• Familiarity and hands-on experience coordinating benefits, authorizations, and service eligibility involving multiple payer groups and healthcare resources.
• Comprehensive knowledge of community-based resources, social services, and support networks that impact patient care and wellness.

Located within Wipro LLC’s Business Process Services, this role offers an engaging opportunity for individuals passionate about making a positive impact in healthcare through exemplary service, teamwork, and dedication to patient-centered care. The position is eligible for a comprehensive benefits package and a compensation range that reflects market competitiveness and regional variations.