Healthcare Pre authorization Representative

Wipro; Tampa (FL); Remote; USD 40,000 - 60,000; Full time

Job summary

Join a leading company as a Healthcare Pre-authorization Representative, where you will provide vital customer service in a remote position. This role involves coordinating authorizations and requests, requiring excellent communication and organizational skills. With opportunities for advancement and a comprehensive benefits package, Wipro offers a dynamic work environment focused on healthcare transformation.

Benefits

Competitive hourly pay

Opportunities for career advancement

Day one benefits

Work from home

Qualifications

• 2+ years of experience in healthcare or customer service setting.
• Proficiency in Microsoft Office including Word and Excel.
• Knowledge of ICD-9/ICD-10 and CPT.

Responsibilities

• Manage authorizations and notifications from incoming requests.
• Provide excellent customer service and handle escalated calls.
• Coordinate with Medical Directors and other departments.

Skills

Customer service

Coordination

Authorization skills

Microsoft Office

Medical Terminology

Education

High School Diploma / GED

Job description

Join to apply for the Healthcare Pre authorization Representative role at Wipro

Join to apply for the Healthcare Pre authorization Representative role at Wipro

Get AI-powered advice on this job and more exclusive features.

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.

Wipro is a leading, publicly traded, global IT solutions and services company with over 230,000 dedicated employees serving clients across multiple continents and over sixty countries.

We offer a strong compensation package that includes competitive hourly pay, the ability to work overtime, and day one benefits. Wipro also offers many opportunities for career advancement within our engaging and exciting culture.

Job-Type: This is a remote/work from home (WFH), full-time direct hire position.

Work authorization: US Citizen or US Green Card only

Training: Employees must be able to work from 8am-5pm CST M-F during our 6-week training program. Post training shifts may vary. Training will be conducted virtually from your home.

Post Training: After 6 week training, this position is full-time (40 hours/ week) with variable (varying) shifts to support our 24 hour a day, 7 days per week operations. Must be able to work Saturdays.

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.SM

We provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient’s health. We have a proactive approach focuses on prevention and the complete coordination of care for patients.

Under the supervision of the Network Operations Supervisor, this position is responsible for the daily coordination of Network Ops processes in the Intake Call Center. This position serves as the initial intake of pre - service requests, claim reviews and inpatient hospital coordination and diabetic supplies. Coordinates Network Operations processes with Medical Directors, Network Operations Nurses, hospitals, physicians and other various departments. Provides clerical support to clinical staff in their medical necessity review process. The Intake Coordinator is expected to maintain production and quality standards.

· 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

· 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.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

· High School Diploma / GED (or higher)

· 2+ years of combined or related experience in a healthcare, call center, and/or customer service setting using the telephone and computer as the primary instrument to perform job duties

· Ability to work one of the varying shift to support our 24hr 7 days a week operations

· Proficiency with Microsoft Office Word (create and maintain documents), Excel (create and maintain spreadsheets) and Outlook(email and calendaring) Medical Terminology

· ICD-9/ICD-10 and CPT Knowledge

· Required to have a dedicated work area established that is HIPPA compliant.

· Ability to keep all company sensitive documents secure (if applicable)

· Must live in a location that can receive approved high-speed internet connection or leverage an existing high-speed internet service

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Sales and Business Development

• Industries

  IT Services and IT Consulting

Referrals increase your chances of interviewing at Wipro by 2x

Get notified about new Healthcare Representative jobs in Tampa, FL.

Pharmaceutical Sales Representative- Medical Dermatology

Medical Equipment Florida Territory Sales Rep

Medical Office Rep Pool - Tampa Bay & Surrounding Areas

Medical Office Rep - Pinellas County Float Team

Medical Office Rep - Tampa - Bilingual in English & Spanish

Medical Equipment Customer Service Representative

St. Petersburg, FL $20.00-$25.00 1 week ago

Community Liaison – Medical Group| Tampa

Tampa, FL $98,000.00-$118,000.00 17 hours ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.