Analyst - Business Process (Healthcare)

Wipro Technologies; Tampa (FL); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading technology services and consulting company seeks a Business Process Analyst in the healthcare sector to manage client services. You'll be vital to analyzing inquiries and collaborating with diverse teams to ensure client satisfaction while adhering to all regulatory guidelines.

Qualifications

• High School diploma or GED required.
• Skills in problem-solving and benefit plan interpretation.
• Knowledge of medical codes (CPT, ICD9/ICD10) is advantageous.

Responsibilities

• Coordinate review and response of client inquiries, ensuring accuracy.
• Assist in researching complaints and collaborating with teams.
• Manage client communications and track inquiry volumes.

Skills

Problem-solving

Benefit plan interpretation

Knowledge of CPT codes

Knowledge of ICD9/ICD10 codes

Medical terminology

Ability to work independently

Average typing ability

Education

High School/GED

Job description

Search by ‘Skills’ or ‘Keywords’ or 'Requisition ID’

Search by Location

Select how often (in days) to receive an alert:

Work with us

Title: Analyst - Business Process (Healthcare)

Requisition ID: 63877

City: Tampa

Country/Region: US

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

The Client Services Analyst will be a vital member of the ASO Claims department and report to the ASO Operations Lead. They will assist the department with overseeing client services and satisfaction, manage a small client services mailbox, create and maintain communications with clients and providers, and collaborate with various departments.

ESSENTIAL JOB FUNCTIONS/DUTIES

• Coordinate review and response of inquiries, ensuring accuracy, timeliness, and proper documentation.
• Coordinate review and response to provider disputes, meeting all guidelines.
• Assist in researching and responding to complaints, collaborating with internal and external teams.
• Follow all HIPAA guidelines for information release.
• Participate in scheduled client and vendor relationship calls.
• Manage tracking of inquiries from clients and vendors, routing and follow-up.
• Prepare provider communications related to inquiries.
• Track and report inquiry volume.
• Coordinate escalations with medical review to meet timeframes and expectations.
• Interpret Summary Plan Document language.
• Coordinate hand-offs to the adjustment team when disputes are overturned.
• Perform other duties as assigned.

QUALIFICATION REQUIREMENTS

• High School/GED required.
• Skills in problem-solving and benefit plan interpretation.
• Knowledge of CPT codes, ICD9/ICD10 codes, and medical terminology is a plus.
• Ability to work independently.
• Average typing ability.

EDUCATION REQUIREMENTS

Note: Although this role is remote, candidates must reside within 100 miles of Tampa to participate in training and in-person activities.

Join Wipro to reinvent your career. We are committed to diversity and inclusion, welcoming applications from persons with disabilities. For concerns regarding unethical practices, contact our Ombuds Group at [e-mail]. We are an Equal Opportunity Employer, providing accommodations to qualified applicants throughout the process. We value diversity and are committed to creating an accessible, inclusive workplace.