Claims Appeal and Grievance Examiner Position Available In Hillsborough, Florida
Tallo's Job Summary: The Claims Appeal and Grievance Examiner position at Wipro Limited in Tampa, FL involves adjusting medical, dental, and vision claims, coordinating appeals, responding to provider disputes, and ensuring compliance with HIPAA guidelines. Qualifications include problem-solving skills, benefit plan interpretation, and knowledge of medical codes. The role requires a High School Diploma with an average salary range. Join Wipro to reinvent your career and skills.
Job Description
Claims Appeal and Grievance Examiner 3.8 3.8 out of 5 stars Tampa, FL 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 The Claims Adjustment Examiner position responsible for adjusting medical, dental and vision claims.
ESSENTIAL JOB FUNCTIONS/DUTIES
Coordinate the review and response of member appeals meeting all Department of Labor and client requested guidelines for accuracy, timeliness and documentation Coordinate the review and response to provider disputes meeting all client requested guidelines for accuracy, timeliness and documentation Work with other responsible teams to assist in the research and response to complaints. Teams may be internal or external Follow all HIPAA guidelines for the release of information Coordinate escalations with medical review and follow-up timely to assure timeframes and client expectations are met Interpret Summary Plan Document language Coordinate the hand off to adjustment team when a dispute is over-turned Other duties as assigned
QUALIFICATION REQUIREMENTS
High School/GED required Demonstrate skills in problem solving and benefit plan interpretation Knowledge of CPT codes, ICD9/ICD10 codes and/or medical terminology is a plus Ability to work independently PC proficiency Average typing ability
EDUCATION REQUIREMENTS
High School Diploma required, Associates degree preferred
PHYSICAL REQUIREMENTS
Working conditions are normal for an office environment. May be subject to interruptions. Minimal physical exertion. Required to work on a computer. Expected annual pay for this role ranges from to . 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 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.
