Claims Examiner
: Job Details :

Here we grow again with new opportunities! Wipro is seeking individuals who combine excellent customer service and problem-solving skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team. Wipro is a leading global IT Solutions and Services company with over 200,000 dedicated employees serving clients across more than 66 countries. We offer a strong compensation package that includes competitive pay and day one benefits. Wipro also offers many opportunities for career advancement within our engaging and exciting culture. Onsite 3701 Boardman Canfield Rd., Bldg. B, Canfield Ohio 44406 USC and Green Card only No relocation The Claims Analyst position responsible for adjusting medical, dental and vision claims.

• Review and adjust 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 adjusters
• Properly assign over-payments and refunds to existing balances
• 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
• Other duties as assigned

• 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