PRODUCTION AGENT L1

Production Agent L1

Tampa, Florida

Wipro Limited 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.

Job Description: Role Purpose The purpose of the role is to provide effective technical support to the process and actively resolve client issues directly or through timely escalation to meet process SLAs. Purpose of Job: Positions in this function are responsible to determine if prior authorization is required and can be decisioned, or if it requires additional clinical review. Individuals support clinicians by contacting health providers and/or members to verify authorization or referral, setup cases, and document findings. Positions in this function includes those responsible for initial triage of members, administrative intake of members and working with hospitals and the clinical team.

Primary Responsibilities:

• This is a production role 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 outbound calls to providers to coordinate provider availability in treating members
• Other duties as assigned by manager and/or director.

Qualifications Required:

• Minimum of a High School Diploma / GED
• 1+ years of professional experience in an office or healthcare environment
• Prior customer service experience making outbound calls
• Prior Work from home experience
• Proficiency in using a computer
• Experience working with Microsoft Office Products including Microsoft Outlook (ability to create, edit, save, and send emails), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets)
• Flexibility to work outside standard hours of operations due to changing business needs
• Ability to trouble shoot and setup computer equipment independently
• Must have a designated work area established that is separate from other living areas and can be secured to maintain PHI or PI security in line with UnitedHealth Group policies and standards

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

The expected compensation for this role ranges from $25,000 to $50,000. Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. 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.

Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.