Medical Claim Examiner (Tampa, USA-FL, US, 33634)

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. 

Job Description

Medical Claims Examiner I

Location: Remote, US only

Work authorization: US Citizen or US Green Card only

Hours: Mon- Fri 7:30AM -3:30 PM EST or 8:00 AM - 4:30 PM EST

Compensation: $20 per hour

Position Summary: The Medical Claims Examiner I position is responsible for processing medical, dental and vision claims. In this pivotal role, you will demonstrate skills in problem solving and benefit plan interpretation. This includes providing comprehensive customer support, addressing inquiries and resolving issues with professionalism and efficiency. You will play a crucial role in fostering positive customer relationships as well as ensuring every customer feels valued and supported.

Additional Job Duties

• Review and process medical claims according to Plan guidelines within established turnaround time frames.
• Interpret medical plan to assure system is coded correctly.
• Review claims for legitimacy and accuracy
• Meet production and quality standards set for examiners
• Work Customer Service inquiries related to claim questions.
• Review correspondence submitted by members and providers and adjust all related claims if the additional documentation submitted warrants adjustment

Requirements

• High School Diploma or GED required
• Minimum 1 year of experience with Medical claims
• Demonstrated skills in problem solving and benefit plan interpretation

Preferences

• Knowledge of CPT codes, ICD9/ICD10 codes and/or medical terminology is a plus

The expected compensation for this role ranges from $19 to $20/per hour. 

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. Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.

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.

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.