Saraswathi S Mesta

Humana Process - Quoting

• Our role is to create a quote for a large group that has 300 to 999 employees in the ARC application.
• Quoted request is sent through mail by sales and need to create it and send back within 5 days of cycle time.
• Working in ARC application which has Account, Opportunity, Pursuit and LG quote request screen.
• We need to check the correct address, SIC code of the given group, and validate it.
• Need to validate the producer and agency through their SAN or HAN number. If not validating, need to consider different producers and agencies by sales confirmation.
• Need to format the Excel file of employees (300-999) to check whether they have provided the correct gender, DOB, coverage type, DOH, salary, class etc., for Dental, Vision, Basic life, Voluntary life, Short-term Disability and Long-term Disability through VLOOKUP formula.
• Working on Cobra and retired employees if it is given in Excel.
• Annual rate will be given and we need to create premium for group.
• Working on additional applications, like the Rating module, SRS, DINS, and Aprio, to fill in other details of the group.
• Working on Special request like Geo excess, Network 360 and Distribution analysis.
• Macess application used to complete work item

RECONCILIATION

• Our role was to verify members addresses and to give them a Medicare plan according to the place where they live (State and county)
• Work item pulled from Market Prominence and need to check where members is active or not.
• We need to terminate the Medicare plan of the member if they are moving to a different state, and knowing them to obtain a new plan through a call.
• We need to collect addresses from recent sources, which may be Genesys, CRM, DAN, SPIDAR.
• Cerface interface application is used to term the Medicare plan and to change the address.
• Working on Genesys application to listen the call to know more information about POA, plan, address of member.