Health Insurance Customer Service Agent

Wipro; Atlanta (GA); On-site; USD 25,000 - 50,000; Full time

Job summary

Wipro is looking for a Health Insurance Customer Service Agent in Atlanta, GA. The role involves managing service requests, providing support to clients, and ensuring high-quality customer service through effective communication. Ideal candidates will have skills in claims processing and a commitment to customer satisfaction, with competitive annual pay ranging from $25,000 to $50,000.

Benefits

Full range of medical and dental benefits

Disability insurance

Paid time off including sick leave

Qualifications

• Experience in claims processing required.
• Ability to deliver excellent customer service and troubleshoot client queries.
• Coordination skills and ability to work under pressure.

Responsibilities

• Manage authorizations, notifications and service requests via phone and faxes.
• Provide product support to clients and troubleshoot queries.
• Maintain logs of customer interactions and ensure compliance with service standards.

Skills

Claims Processing

Job description

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We are continuing to grow! Come grow with us!!!

Wipro is seeking customer service/claims processors who combine excellent coordination and authorization skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team

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Job description:

Job Description

We are continuing to grow! Come grow with us!!!

Wipro is seeking customer service/claims processors who combine excellent coordination and authorization skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team

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Primary Responsibilities:

• Managing authorizations / notifications and other service requests received via incoming phone calls, faxes and portal submission
  Providing excellent customer service, including the ability to handle escalated callers
  Determining authorization or notification requirements
  Preparing authorization cases for Medical Directors, Network Operations Nurses and Case Managers
  Providing administrative approvals (depends on line of business)
  Handling expedited authorizations, authorization updates and status checks
  Confirming member eligibility
  Outreaches to providers and/or Patient to complete authorization requests and prescriptions
  Maintaining knowledge of various health plan partner benefits, networks, CMS regulations and health plan partner policies
  Utilizing experience and judgement to plan, accomplish goals and effectively resolve each assigned task
  Non-Clinical staff is not responsible for conducting any Network Operations activity that requires interpretation of clinical information.
  Performs all other related duties as assigned.

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• Deliver excellent customer service through effective diagnosis and troubleshooting of client queries
  • Provide product support and resolution to clients by performing a question diagnosis while guiding users through step-by-step solutions
  • Assist clients with navigating around product menus and facilitate better understanding of product features
  • Troubleshoot all client queries in a user-friendly, courteous and professional manner
  • Maintain logs and records of all customer queries as per the standard procedures and guidelines
  • Accurately process and record all incoming call and email using the designated tracking software
  • Offer alternative solutions to clients (where appropriate) with the objective of retaining customers’ and clients’ business
  • Organize ideas and effectively communicate oral messages appropriate to listeners and situations
  • Follow up and make scheduled call backs to customers to record feedback and ensure compliance to contract /SLAs

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• Build capability to ensure operational excellence and maintain superior customer service levels of the existing account/client
  • Undertake product trainings to stay current with product features, changes and updates
  • Enroll in product specific and any other trainings per client requirements/recommendations
  • Partner with team leaders to brainstorm and identify training themes and learning issues to better serve the client
  • Update job knowledge by participating in self learning opportunities and maintaining personal networks

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Deliver

NoPerformance ParameterMeasure1ProcessNo. of cases resolved per day, compliance to process and quality standards, meeting process level SLAs, Pulse score, Customer feedback2Self- ManagementProductivity, efficiency, absenteeism, Training Hours, No of technical training completed

Mandatory Skills: Claims_Processing .

Expected annual pay for this role ranges from $25,000 to $50,000 . 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.

Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention. Come to Wipro. Realize your ambitions. Applications from people with disabilities are explicitly welcome.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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