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Path to Proficiency - Coggle Diagram
Path to Proficiency
By Business Unit
UAE
MCC
EGY
Data Sources
Username Dictionary
Processing Logs -
Processing User Name
PC Logs -
User_Name
Cisco username
- ??
Employee Data / Tenure
User Role
Ex : Claims Management Processor
Claims Management Coordinator
Productivity Volumes Data
Processing Logs
ASOAP Table
Cisco CUIC
Quality Data
Volume Targets
Claims
Claims Management Processor
DB Claims
Type of DB Claim
E-Claims (Resubmission) - 7,150 claims/month
Processing Paper Claims (Initial) - 6,160 claims/month
Government - 4,400 claims/month
RI Claims
Type of RI Claim
Out-patient Claims (Initial) - 1,210 claims/month
In-patient Claims (Resubmission) - 1,210 claims/month
In-patient Claims (Initial) - 1,210 claims/month
Out-patient Claims (Resubmission) - 1,210 claims/month
Claims Management Coordinator
DB Claims
Tracking - 33,000 claims/month, Scanning - 22,000 claims/month,
PO Preparation - 6,160 POs/month
PO Releasing - 55,000 POs/month
Helpline
QA Targets
Claims Management Coordinator
99.5% accuracy of claims/ invoice tracked, and scanned
99.5% accuracy of the Payment Orders prepared and released (OFR, escalations)
Claims Management Processor
99.5% accuracy
per day/ per month
via OFR
Milestones
Claims Management Processor
Month 1 -
35% Productivity with 95% quality- ,
Month 2 -
85% Productivity with 97% quality,
Month 3 -
100% Productivity with 99% quality
Week 1 - Orientation and Hands-on - All Tasks performed subject for review and evaluation,
Claims Management Coordinator
Week 1 - Orientation and Hands-on - All Tasks performed subject for review and evaluation,
Month1 -
35% Productivity with 95% quality- ,
Month 2 -
85% Productivity with 97% quality,
Month 3 -
100% Productivity with 99% quality