Customer Service Advisor - Remote Healthcare Operations in Alabama - Prior Authorization and Member Support

Join Our Team: Customer Service Advisor - Remote in Alabama Are you a motivated and compassionate individual with a passion for delivering exceptional customer service in the healthcare industry? Do you have a strong background in problem-solving and a keen understanding of medical terminology? Wipro, a leading global IT solutions and services company, is seeking talented Customer Service Advisors to join our remote team in Alabama. As a Customer Service Advisor, you will play a vital role in supporting our healthcare clients and members, ensuring seamless prior authorization and enrollment processes. About Wipro and Our Culture Wipro is a global leader in IT solutions and services, with over 240,000 dedicated employees serving clients across multiple continents and 66 countries. Our company is built on a foundation of innovation, integrity, and customer satisfaction. We offer a dynamic and engaging work environment that fosters growth, learning, and collaboration. Our culture is centered around our values of: • Innovation: We encourage creativity and innovation in everything we do. • Integrity: We operate with transparency, honesty, and ethics. • Customer Satisfaction: We are committed to delivering exceptional service and value to our clients. Job Summary As a Customer Service Advisor, you will work in a remote call center environment, supporting our healthcare clients and members with prior authorization and enrollment processes. You will be responsible for reviewing and determining the eligibility of members for various healthcare programs, such as cancer, kidney, artificial hearts, and orthopedic programs. Your exceptional problem-solving skills, combined with your knowledge of medical terminology, will enable you to effectively navigate complex cases and provide personalized support to members and healthcare providers. Key Responsibilities: • Prior Authorization and Enrollment: Review and process prior authorization requests, ensuring accurate and timely enrollment of members into various healthcare programs. • Member Support: Provide exceptional customer service to members and healthcare providers, responding to inquiries and resolving issues in a professional and courteous manner. • Case Management: Review and manage cases, ensuring accurate documentation and information gathering. • Clinical Review: Conduct clinical reviews to determine if cases require additional review or can be decisioned. • Communication: Make outbound calls to providers and members to obtain information, coordinate provider availability, and communicate program details. • Documentation and Reporting: Maintain accurate records and reports, ensuring compliance with regulatory requirements and company policies. Requirements and Qualifications Essential Qualifications: • Education: High School Diploma or GED (or higher) - documentation required for verification. • Experience: 2+ years of combined or related experience in healthcare administration, with a strong understanding of medical terminology. • Call Center Experience: 1+ year of call center experience. • Technical Skills: Proficiency with Microsoft Office Word, Excel, and Outlook; typing speed of 35+ WPM. • Work Environment: Dedicated work area, separated from other living areas, with high-speed internet (20mbps upload/download speed). • Availability: Ability to work varying shifts, including days, evenings, and weekends, to support 24/7 operations. Preferred Qualifications: • Education: Associate's Degree (or higher) in a healthcare-related field. • Medical Terminology: Advanced knowledge of medical terminology. • ICD-9/ICD-10 and CPT Knowledge: Familiarity with ICD-9/ICD-10 and CPT coding systems. What We Offer At Wipro, we offer a comprehensive compensation package that includes: • Competitive Salary: A competitive salary range for this role. • Benefits: Day-one benefits, including medical, dental, and vision coverage. • Career Growth Opportunities: Opportunities for career advancement and professional growth within our company. • Learning and Development: Access to training and development programs to enhance your skills and knowledge. • Remote Work Environment: The flexibility to work from home, with a dedicated work area. Why Join Our Team? By joining our team as a Customer Service Advisor, you will have the opportunity to: • Make a Difference: Contribute to the delivery of exceptional customer service in the healthcare industry. • Grow Professionally: Develop your skills and knowledge in a dynamic and supportive work environment. • Work with a Global Leader: Collaborate with a leading global IT solutions and services company. • Enjoy a Flexible Work Environment: Work from home, with a dedicated work area, and flexible scheduling. Ready to Apply? If you are a motivated and compassionate individual with a passion for delivering exceptional customer service, we encourage you to apply now! Please click the link below to submit your application. Apply for this job Apply tot his job