HirePortal

Executive – Customer Care Medical Voice

  • EXL
  • Cape Town, South Africa
  • ZAR 120,000 – ZAR 180,000

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.

Navigate through multiple systems / applications for data gathering • Proficiency with computer skills (navigating multiple systems and keyboarding) • 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 • Tying speed – 25-30 words/minute with 90% accuracy • Must be flexible to work hours with Monthly work schedules changes

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”

Skills

  • Data Entry
  • Medical terminology
  • Claims Processing
  • Compliance Verification
  • Typing (25-30 WPM)
  • Customer Service
  • System Navigation

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