Modernizing Business Processes For Effective Insurance Claims Management

By Author: Nate Rodney
Total Articles: 499
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Gaining efficiency can be achieved in several ways in the insurance claim management process. As claim managers begin to delve deeper into taking their claims processing system to the next level it is important to first identify and streamline your business processes to achieve effective claims management. Given the complexities of scenarios that come up during the claim management workflow a continuous process improvement plan should be implemented. As you explore your workflow, evaluate the impact that each process will have on the bottom line and also how they will impact your customers, employees and business partners.

Adding in a structured business operations process equips claim managers with complete control over their processes and therefore able to realize the full potential of their organization’s productivity. IT modernization has become more than just technology. Taking a hard look at how you can improve each business process can completely modernized your workflow, and contains costs.

Applying the rigors of business process management and automating critical processes are first steps in continuing ...
... process improvement. It is also important for each adjuster to identify their business process and to understand how they can be improved.

A few items to take a close look when evaluating each process are:

What information do you add to each claim and why is it needed?

What information do you consistently pull from one document to the next and how an automated feature can assist you?

Breakdown your workflow into specific steps to define each process. The more specific the better.

What do the people immediately before and after you in the flow of the process do?

Requesting info from employees who are a part of the process in the work-flow chain will give you input on ways to improve efficiency.

How efficient is your current claims processing workflow? What are the missing links that can take at least 10 minutes off your workflow chain?

As you create the process sheer repetition helps to present ad hoc ideas and processes become included in the standard workflow model. Many cases have found that an employee has already collectively put together a work around in their work flow process and that is great starting point to begin making immediate changes. Start with the obvious low-hanging fruit. Claim systems and IT technology has grown by leaps and bounds and now puts you and your customer in the driver seat. Take advantage of the opportunity of creating a customized insurance claims processing software that provides your organization the most complete solution possible.

JDi Data Corporation has provided insurance claims software since 1992. Our product suite includes workers compensation software and claims management systems for property and casualty, medical malpractice, and specialty lines to be administered by insurers, risk managers, and third party administrators. JDi Data has built a reputation in quality claims management software with special emphasis on complex litigation.