Appeals Coders

Wipro•Atlanta, GA

About The Position

The Appeals Coder provides technical and process support by handling client transactions according to quality standards and resolving client issues directly or escalating them promptly to meet service-level agreements. The role involves receiving and documenting client requests, troubleshooting questions, maintaining accurate records, and providing clear, courteous support through telephone and email. It also includes learning product information, keeping support materials current, participating in training, and working with team leaders to improve service and operational performance.

Requirements

Mandatory skill: Claims Processing.

Responsibilities

Manage process transactions in accordance with required quality standards.
Handle incoming client requests by telephone and email in a courteous manner.
Record client identification details and document queries, troubleshooting steps, and resolution outcomes.
Update availability in the RAVE system and maintain productivity.
Follow standard procedures and resolve client queries in line with contract SLAs.
Use internal knowledge bases, resources, and FAQs to support problem resolution.
Learn product details and help clients navigate product menus and understand product features.
Analyze call logs for recurring trends and maintain customer self-help documents.
Escalate serious issues to the Team Leader when resolution is delayed.
Provide required product information and disclosures before and after client interactions, and comply with service agreements.
Diagnose and troubleshoot client questions, guiding users through step-by-step solutions in a professional manner.
Process and record calls and emails using designated tracking software; maintain query logs and records.
Offer appropriate alternative solutions to help retain customers and clients.
Make scheduled follow-up calls to collect feedback and ensure compliance with contracts and SLAs.
Participate in product and other required training, collaborate with team leaders to identify learning needs, and update job knowledge through self-learning.
Meet process and self-management performance measures, including cases resolved, quality and SLA compliance, customer feedback, productivity, efficiency, attendance, and training.