Optimizing Insurance Claims Management for Improved Operational Performance

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Companies are now looking to claims manager to reduce cycle time with innovative ways to improve the claims process and enhance the customer’s experience. Claims handling can be looked at as a very intricate process. From receiving a claim to paying out a claim there are several detailed workflow processes that should be paid attention to closely in order to have a smooth transition. With the proper insight and enhanced claim methods, adjusters can turn claims management into a process to improve operational performance and workflow productivity.
Let’s dive a little deeper into the claims management process with a breakdown of the important moments in each claim.

First Notice of Loss (FNOL) is client driven, and provides the first step in enhancing your customer’s experience. Streamline this critical internal process with the option for the claim to be entered by the claimant, HR, lawyer, and/or broker with established system business rules that follow the reporting process. The end result is a dynamic first notice of loss workflow.
Acceptance, evaluation, and approval are the meat of the claims management process. For insurance carriers, the demand is to not only provide an optimal customer experience with fair settlements, but also micro manage the behind the scenes details. Implementing client driven business rules creates a stimulated workflow process for claim managers.
Other challenges that present itself during the claims process for claim managers are leveraging the claim data. Claim adjusters look to get integrated outcomes and specific or customized reports generated that an antiquated claims management system may not be able to provide. The capability to generate basic reports is a normal function in a claims processing software. Take the next step to transform claims management by maximizing your reports and implementing sophisticated ad hoc reports. Enhanced reporting helps claim managers to adjust to new market demands to retrieve information and output outcomes to provide better insight for making decisions.
Claims loss payouts allocations are the most important costs to insurance carriers and also have one of the biggest outcomes on underwriting bottom lines. Insurance companies claim process needs to not only be effective but also efficient. Closely observing the end to end process of claims adjudication helps to put together a high level workflow – from receiving a claim to paying out a claim that can be evaluated for improvements. The outcome is contained claim costs, high-quality customer service, operational efficiency, and streamlined internal processes.