Executives

• Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Data gathering requires navigation through multiple system applications

• Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor
• Above average knowledge and skills on MS Applications

• Pro-actively and consistently applies the regulatory and accreditation standards to assure that activities are reviewed and processed within guidelines

EXL Service