Modernizing Business Processes for Effective Insurance Claims Management

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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.

Effective claims manager

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. Joe McKendrick of Insurance Network News wrote a great post on looking at IT modernization as more than just technology.
Joe noted that Jack Vaughan of the Army and Air Force Mutual Aid Association (AAFMAA) completely modernized their workflow, cut costs, and increased sales by taking a hard look at how they could improve each business process.

The project couldn’t have been done without applying the rigors of business process management (BPM), Jack relates.

AAFMAA, which provides insurance and related services directly to U.S. military personnel, set out to cut costs through automation and boost sales through technology. The insurer had mainframe systems it wanted to retain and connect to its Java and NET-platform-based systems.

“The main thing for us is continuous process improvement. The key is to make sure, number one, that organizations can identify their business processes,” says Amarish Pathak, CIO of AAFMAA. “Then they can start to measure the performance of those processes and to understand how they can be improved.”

A few items to take a close look at 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?
  • Break down your workflow into specific steps to define each process. The more specific the better.
  • Requesting info from employees who are a part of the process in the workflow chain will give you input on ways to improve efficiency.
  • How efficient are 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 workaround in their workflow process and that is great starting point to begin making immediate changes. Start with the obvious low-hanging fruit. Claim systems and IT technology have grown by leaps and bounds and now put you and your customer in the driver’s seat. Take advantage of the opportunity of creating a customized insurance claims processing software that provides your organization with the most complete solution possible.