Skip to main content

         This documentation site is for previous versions. Visit our new documentation site for current releases.      

Skill based routing

Updated on December 16, 2021

To support claims and claims inquiry routing and review in Pega Smart Claims Engine for Healthcare (SCE), two models are implemented. The first is work queue-based routing, which controls where work items are routed. The second is skill-based routing, which filters the type of work an individual can retrieve from the work queue. Pega Smart Claims Engine for Healthcare provides configurations for skills-based routing for both claims and claim inquiries.

Pega Marketing User Guide

The retrieval of work by using skill-based routing enables efficient routing of claims or claim inquiries only to claims examiners who have the appropriate skills. This improves operations by ensuring that the right operator can always work on the right piece of work.

Have a question? Get answers now.

Visit the Support Center to ask questions, engage in discussions, share ideas, and help others.

Did you find this content helpful?

Want to help us improve this content?

We'd prefer it if you saw us at our best. is not optimized for Internet Explorer. For the optimal experience, please use:

Close Deprecation Notice
Contact us