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Default workbaskets

Updated on April 26, 2021

This table lists the default work groups and workbaskets used in Smart Claims Engine.

Workbasket nameOrganizationDivisionUnitWorkgroupUsers
CE_ClaimsOperationsWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Junior Claims Examiner, Senior Claims Examiner, Claims Supervisor
CE_ClaimsAuditsWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanSenior Claims Examiner,Claims Supervisor
CE_ClaimsCOBWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Senior Claims Examiner, Claims Supervisor
CE_ClaimsMemberWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Senior Claims Examiner, Claims Supervisor
CE_ClaimsProviderWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Senior Claims Examiner, Claims Supervisor

CE_ClaimsPricingWB

MyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Senior Claims Examiner, Claims Supervisor

CE_ClaimsManagementWB

MyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Manager, Claims Supervisor
CE_SystemConfigurationWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner
CE_SystemOperationsWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanSenior Claims Examiner
CE_SystemManagementWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanBusiness Analysis
ClaimsInquiryWBMyHealthPlanclaimsclaimsClaims@MyHealthPlanClaims Examiner, Junior Claims Examiner, Senior Claims Examiner, Claims Supervisor

Tags

Pega Smart Claims Engine for Healthcare 8.6

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