Executive-Customer Care Medical Voice
EXL · Cape Town, Western Cape
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The intake agent will receive and review the fax images and start data entry in the system. • Validate and verify the provider and member using all compliance metrics. • Create the precert case and route the case to the appropriate bucket for initial or final review. • Attach the fax for existing precert cases needing additional information. • Intake agent needs to determine whether case should be cancelled or build • Investigate previous case history to determine case outcome • Fax back providers • Research certain drugs • Data capture from system to template.
RESPONSIBILITIES
Navigate through multiple system / applications for data gathering • The intake agent will receive and review the fax images and start data entry in the system • Understand the goals and standards to ensure that quality and productivity standards are met • Accurate and timely updating of the database • Meet the agreed upon KPIs as per the operational definitions and targets • Participate in the User Acceptance Testing as needed • 98% - 100% attendance during training/nesting period is required • Must be flexible to work hours with Monthly work schedules changes
QUALIFICATIONS
Education Level - High School Graduate (NSC
"In alignment with the Employment Equity Act, preference will be given to applicants from historically underrepresented groups/ aligned with our EE targets"