Executives
EXL Service
- Pune, Maharashtra
- Permanent
- Full-time
- Screens requests in order to appropriately refer items to the medical services staff
- Utilizes reference tools to determine the need for notification and medical review
- Collates medical information and determines precertification review in accordance with the benefit plan
- Assigns length of stay based on approved reference tools for certain elective inpatient surgical procedures
- Pend cases that require medical review
- Appropriately identifies cases for case management and disease management
- Performs Non-medical research including eligibility verification, coordination of benefits and benefits verification
- OUTPUT: Medical procedures/ services authorized or cases created and sent to clinicians for review.