***THIS POSITION IS OPEN FOR REMOTE WORKING***

Wipro is recruiting motivated performers to join our fast-paced and highly supportive virtual CBO
as physician Call Services Team Leads / SMEs. We are seeking candidates with a minimum of 2-3
years' physician call center, billing, reimbursement, and/or third-party follow-up experience. We
need people experienced with variety of payers, including Managed Care, Medicare, Medicaid,
Workers' Comp, Commercial, and others. Successful candidates will be physician- and patientu0002focused, able to consistently produce high-quality work, able to serve as OJT resources for their
colleagues, collaborative and collegial, and personable and courteous. They will have excellent
customer-service skills with patients and guarantors (especially on inbound calls), will always
demonstrate professionalism, and will be skilled in time management and work prioritization.

As a Team Lead / SME, the employee will provide best-practice subject-matter expertise and
general administrative support to Agents on their assigned team. Additionally, the Team Lead /
SME will function as a working member of their team, reporting directly to their Supervisor about
routine assignments, as detailed below. Further, the Team Lead / SME will also successfully
complete special assignments and other duties, as requested by management. In partnership with
their team's Quality Assurance colleague, the Team Lead / SME will routinely conduct qualityu0002assurance audits for their team's Agents and provide feedback, coaching, and documentation to
each audited Agent and their mutual Supervisor.
As mentioned above, Team Leads / SMEs will serve as working members of their teams. Typically,
they may handle more-complex calls and situations among the team's inventory, while receiving
incoming calls from patients and guarantors. Using excellent customer-service skills, Team Leads /
SMEs will listen to, understand, and resolve callers' requests. Team Leads / SMEs will apply
knowledge of their specialty's clinical care, charging, billing, and reimbursement processes to
assist callers. Team Leads / SMEs will select the next best action(s) necessary to resolve patient
inquiries satisfactorily and completely.
• Ability to perform all team's assigned tasks and clearly articulate related instructions
and directions to colleagues.• Ability to effectively escalate process, HR, IT, and patient- and provider-related issues
to management.• Ability to act as an information resource for all team colleagues and other colleagues
throughout the organization. • Ability to assist supervisor to support team's colleagues with answers to general
caller inquiries, RCM questions, IT-system concerns, claim / account issues, AR trends,
etc.• Ability to effectively deliver OJT instruction and coaching to team colleagues.• Ability to receive and resolve high volumes of medium complexity calls from patients
and guarantors in a call center environment.• Ability to resolve callers' inquiries at first instance of contact.• Ability to gather, classify, and evaluate information about the quality and
completeness of demographic, charging, and billing data, to determine interactions
between billing, revenue, and clinical data, and to consider, select, and perform
correct actions to answer and resolve callers' inquiries.• Ability to rapidly research available documentation including authorization, nursing
notes, physician documentation, and payers' explanations of benefits, to provide
accurate information and answers to callers while they are connected on the phone.• Ability to understand and explain registration, authorization, billing, insurance followu0002up, and denials processes.• Ability to enter accurate and thorough documentation in client's IT system(s), to
record the reason(s) for and resolution(s) of callers' inquiries.• Ability to select and document necessary after-call actions and perform after-call
analyses to support payer rebilling, follow-up, appeal, and/or other necessary
interventions.• Ability to work independently, with limited supervision.• Ability to recognize calls that require Supervisor or Manager intervention / escalation
and to correctly transfer calls while maintaining caller satisfaction.• Ability to comprehend, understand, interpret, and apply payer contracts and
government-payer reimbursement regulations.• Ability to serve as a source of technical information in assigned responsibility area.• Ability to train others about certain aspects of assigned duties.• Ability to work independently, with limited supervision, following client- and
specialty-specific training.• Ability to write complex business correspondence to insurance companies and
guarantors, using prescribed formats, and conforming to all rules of punctuation,
grammar, diction, and style.• Ability to read and comprehend policy and procedure documentation, billing
documentation, memoranda, correspondence, dictionaries, and thesauruses
• Ability to compute ratios, proportions, fractions, and percentages, and ability to
apply standard arithmetic functions.• Ability to comprehend and apply accounting concepts, including debits / credits and
positive / negative numbers.• Ability to apply common sense to carry out instructions furnished in written, oral, or
diagrammatic form.• Ability to deal with problems involving several concrete variables, in or from
standardized situations.• Ability to operate standard office equipment: computer; telephone; copier; fax and
calculator• Ability to type 45-60 CWPM
• High School diploma or equivalent; Preference given to AS / AA degrees or above• 2-3 years physician / ambulatory call center, billing, collections, and/or denials exp.• Productivity and quality-based evaluation-management experience• MD practice-management / EHR-system experience, especially MDIV and/or EPIC• Major payer and related IT-systems experience• Healthcare terminology and CPT-4
® + ICD-10® coding familiarity• Microsoft Office knowledge