Job Description

Job Summary

Responsibilities encompass verifying eligibility with end customers, reviewing medical documentation, obtaining prior authorization, requesting missing or incomplete payer information, updating patient information, and performing other necessary actions without the need for a phone call

Key Responsibilities

• Assess and resolve enquiries, requests, and complaints, ensuring customer enquiries are addressed
• Utilize sound judgment and make decisions within established procedures for each service request, including logging, processing, and monitoring enquiries. Adhere to agreed Key Performance Indicators, Service Level Agreements, and quality standards to maximize customer satisfaction.
• Manage and update account-wise customer interactions daily, generated through workflows and queues.
• Achieve key and critical performance targets.
• Ensure efficiency measures are met in accordance with performance targets and process guidelines.
• Use business tools and industry knowledge updates to identify problem areas and document business requirements through various updates and training sessions.
• Maintain effective work procedures as per client process workflows and HCL policy guidelines.
• Adhere to US healthcare compliance measures.

Skill Requirements

• Written English communication skills
• Good data entry & typing skills
• Ability to multitask.
• Ability to contribute to the process through improvement ideas.
• Analytical and problem-solving skills on the process.

To use sound judgment and take decisions

Other Requirements

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