As a Health Insurance Customer Service Advocate, you will work with members and health providers for Prior Auth creation and review pending statuses. This position helps to enroll our members into CMC programs such as cancer, kidney, artificial hearts, ortho etc. You will review if the member's policy have access, review qualifications, inform what program are available for them and set up appointments with providers.

The position is remote but does require you to be available to work 8 hours per day - Monday thru Friday 7am-7pm CST

Inbound Call Center Agent - Health Insurance

Role & Responsibilities:

• This is a call center production role for Inbound Calls and you will have the responsibility to meet production, quality and regulatory expectations
• Ensure case is set up correctly and document required information
• Review, research and determine if case can be decisioned or if it requires additional clinical review
• Demonstrate proficiency and decision making by solving complex problems using available resources (documents, medical policy, standard operating procedure, etc.)
• As needed, make outbound calls to providers and/or members to obtain information regarding a case
• As needed, make occasional outbound calls to providers to coordinate provider availability in treating members

Qualifications Preferred:

• Previous experience working with back office medical platforms and/or authorizations systems

• Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical Terminology, ICD-10 and CPT codes, Medicare and/or Medicaid Services

• Professional experience in a Clerical or Administrative support related role

• Able to quickly learn various computer systems or applications

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.

If you encounter any suspicious mail, advertisements, or persons who offer jobs at Wipro, please email us at helpdesk.recruitment@wipro.com. 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 ombuds.person@wipro.com.

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.