Job Description
Role Purpose
The purpose of the role is to provide effective technical support to the process and actively resolve client issues directly or through timely escalation to meet process SLAs
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Primary Responsibilities:
· Understands the sensitivity and importance each call scenario presents and handles difficult situations diplomatically and with a professional demeanor
· Actively listens to understand the perspective of others
· Proactively identifies and pursues resolution of issues affecting customer service
· Receive, document, confirm, and resolve/route member, broker, and customer service issues to the appropriate cross-functional team for resolution
· Responds to incoming, telephonic, written or email inquiries from customers or providers regarding eligibility, benefits, claim status/issues, policies & procedures, reimbursement, claims filing and/or appeals/grievances
· May leverage service resources are effectively warm transfer calls to the appropriate area
· Meets or exceeds standards for accessibility, responsiveness, reliability and professionalism
· Meets or exceeds standard for productivity, quality, timeliness and accessibility
· Independently manages inquiry caseload to resolve inquiries in a timely, high-quality manner
· Contributes to high levels of member and client satisfaction by exhibiting timely responds to questions or issues, well developed communication skills and analytical approach to problem solving
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Primary Responsibilities:
· Understands the sensitivity and importance each call scenario presents and handles difficult situations diplomatically and with a professional demeanor
· Actively listens to understand the perspective of others
· Proactively identifies and pursues resolution of issues affecting customer service
· Receive, document, confirm, and resolve/route member, broker, and customer service issues to the appropriate cross-functional team for resolution
· Responds to incoming, telephonic, written or email inquiries from customers or providers regarding eligibility, benefits, claim status/issues, policies & procedures, reimbursement, claims filing and/or appeals/grievances
· May leverage service resources are effectively warm transfer calls to the appropriate area
· Meets or exceeds standards for accessibility, responsiveness, reliability and professionalism
· Meets or exceeds standard for productivity, quality, timeliness and accessibility
· Independently manages inquiry caseload to resolve inquiries in a timely, high-quality manner
· Contributes to high levels of member and client satisfaction by exhibiting timely responds to questions or issues, well developed communication skills and analytical approach to problem solving
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Required Qualifications:
· High School Diploma / GED OR equivalent work experience/School Documentation is required.
· Ability to work full-time, Monday - Friday and have the flexibility to work any of our 8-hour shift schedules during our business hours of 7:00am – 7:00pm CST including the flexibility to work occasional overtime given the business need
Preferred Qualifications:
· 2+ years’ industry experience in health care, preferably in a service role
· 1+ years of experience in a call center environment
· Previous experience in Financials within Health insurance industry
· Data entry experience
· Experience with OnBase
· Experience with LeaveSource
· Experience with Microsoft Office
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Deliver
| No | Performance Parameter | Measure |
| 1 | Process | No. of cases resolved per day, compliance to process and quality standards, meeting process level SLAs, Pulse score, Customer feedback |
| 2 | Self- Management | Productivity, efficiency, absenteeism, Training Hours, No of technical training completed |
Mandatory Skills: Claims_Processing .
The expected compensation for this role ranges from $16/hr to $17/hr.
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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