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Executive-Customer Care Pharmacy-Customer Experience at EXL Talent Acquisition Team
, , South Africa -
Full Time

Start Date

Immediate

Expiry Date

08 Jul, 26

Salary

0.0

Posted On

09 Apr, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Data entry, Compliance verification, Case management, Research, Documentation, Communication, Attention to detail

Industry

Business Consulting and Services

Description
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
The intake agent is responsible for reviewing faxed documents, performing data entry, and verifying provider and member information against compliance metrics. They will also manage precertification cases, investigate case histories, and communicate with providers.