Remote Health Insurance Clinical Coordinator/ Pre Auth

Wipro Technologies; Atlanta (GA); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Remote Health Insurance Clinical Coordinator to join their dynamic team. This full-time position focuses on managing authorizations and notifications while providing exceptional customer service. The role involves coordinating with various healthcare professionals and ensuring efficient processing of service requests. Ideal candidates will have experience in healthcare or customer service settings and be proficient in Microsoft Office. This is a fantastic opportunity to grow within a supportive and inclusive environment, making a real difference in the lives of patients.

Benefits

Competitive hourly pay

Day one benefits

Career advancement opportunities

Work from home flexibility

Qualifications

• 2+ years of experience in healthcare or customer service.
• Ability to work varying shifts to support operations.

Responsibilities

• Manage authorizations and notifications via calls and faxes.
• Provide excellent customer service and handle escalated calls.

Skills

Customer Service

Coordination Skills

Authorization Skills

Medical Terminology

ICD-9/ICD-10 Knowledge

Proficiency in Microsoft Office

Education

High School Diploma / GED

Tools

Microsoft Office Word

Microsoft Excel

Microsoft Outlook

Job description

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Title: Remote Health Insurance Clinical Coordinator/ Pre Auth

Requisition ID: 63778

City: Atlanta

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.

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.

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 achieveyour life’s best work.SM

Weprovides 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 aproactive 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.

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
• 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.

Qualifications:

• 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

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 achieveyour life’s best work.SM

Weprovides 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 aproactive 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.

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
• 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.

Qualifications:

• 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

If you encounter any suspicious mail, advertisements, or persons who offer jobs at Wipro, please email us [e-mail] . 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 [e-mail] .

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.