Jobin Mathew

Senior Process Associate - Operations @WNS

Pune, IN

As a Precert Intake Representative at Aetna, I play a key role in managing the intake and processing of pre-certification requests for medical services. My primary responsibility is to handle incoming calls from healthcare providers, ensuring that all necessary information is collected accurately to facilitate the timely review and approval of services.Key Responsibilities:Precertification Request Intake: Receive and process pre-certification requests from healthcare providers, ensuring that all required clinical documentation and member details are accurately recorded and submitted for review.Provider Support & Communication: Serve as the first point of contact for providers seeking pre-certification for medical procedures, tests, or treatments. Provide guidance on the pre-certification process and any required documentation.Quality Assurance & Compliance: Ensure all interactions and processes adhere to Aetna’s quality standards, regulatory requirements, and HIPAA guidelines, maintaining a high level of accuracy and confidentiality.In this role, I ensure a seamless pre-certification process for both healthcare providers and Aetna members, contributing to the timely approval of medically necessary services while maintaining high standards of customer service and compliance.