Executive-Customer Care Voice-Customer Experience

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.