Medicare and Medicaid Business Services

Wipro offers a comprehensive suite of Medicare and Medicaid Business Services.

Delivered out of our facilities in Jefferson City. MO and Atlanta GA, Wipro’s Business Services operations meet and exceed the required standards set by CMS, HIPAA, and State agencies. 

Our Services Include:

Member Management

  • Eligibility
  • Enrollments
  • Customer / Member Service
  • Fulfillment
  • Field Sales

Revenue Management

  • Premium Billing
  • Financial & Demographic reconciliation with CMS
  • Risk adjusted revenue optimization

Clinical Management

  • Prior authorization intake
  • Prior authorization review (DME, Medical, Behavioral)
  • Medical claim review

Claims Management

  • Claims
  • Intake
    • 1st pass adjudication
    • Rework and adjustment
    • Appeals
  • Provider Calls
  • Provider Data Management

Wipro’s Business Services are tailored ot meet the unique needs of Managed Care plans. Making use of maximum automation, business process re-engineering, and industry-leading best practices, Wipro delivers value and definable ROI to its Business Services clients.

Our team of domain-specific healthcare Subject Matter Experts (SMEs) are available to assist our clients in solving the business challenges of a rapdily changing healthcare environment.