Back Office- Claims Processor (Remote)

Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients' most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world. For additional information, visit us at www.wipro.com.

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. ? 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 - 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. If you encounter any suspicious mail, advertisements, or persons who offer jobs at Wipro, please email us at [email protected]. Do not email your resume to this ID as it is not monitored for resumes and career applications. Any complaints or concerns regarding unethical/unfair hiring practices should be directed to our Ombuds Group at [email protected]. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, caste, creed, religion, gender, marital status, age, ethnic and national origin, gender identity, gender expression, sexual orientation, political orientation, disability status, protected veteran status, or any other characteristic protected by law. Wipro is committed to creating an accessible, supportive, and inclusive workplace. Reasonable accommodation will be provided to all applicants including persons with disabilities, throughout the recruitment and selection process. Accommodations must be communicated in advance of the application, where possible, and will be reviewed on an individual basis. Wipro provides equal opportunities to all and values diversity. Apply Job!