Claims Management Case Study of a US Based Insurer
The client is a well-established insurance company. Their main products are related to health insurance. The client company has also recently taken ownership of other smaller insurance companies dealing in commercial, vehicle, and general liability insurance.
The Challenges
As the company became a significant player in its niche market, its staff experienced a wave of increasing workload, which caused the below-mentioned challenges.
- Working on various data sets
- Excessive workload
- Monitoring each employee’s efficiency and contribution
- Process bottlenecks and related issues
Cogneesol surpassed our expectations by clearing our claims backlog within a couple of weeks. We will surely give them more jobs; excellent service.
The Solution
We provided a solution to help the client achieve long-term benefits, for which we;
Ensured that the outsourced jobs are managed by qualified experts who could comprehend the client’s all requirements and efficiently fulfill their needs. We deployed our skilled professionals having vast experience in the client’s insurance products.
Trained and assigned a dedicated team to assist the client manage their back-office functions, primarily claims management. Another motive here was also to help the client’s staff focus on crucial processes.
Also studied the client’s operational workflow to detect and bridge the gaps. Based on the study results, we helped the client make specific, strategic improvements in processes.
The Impactful Outcomes
We provided complete support with process transformation (moving from traditional to digital insurance systems and software) and management, helping the client considerably improve claims management.
With our highly-energetic and focused insurance support staff, the client experienced a hike of 30% in efficiency.
Consequently, their workload reduced in a matter of a couple of weeks. Besides, our carefully-devised process helped the client resolve almost all operational issues and streamline the entire workflow chain, bringing optimum results. This enabled the client’s staff to get more time to focus on revenue-generating functions.
Client Testimonials
It is always a pleasure to learn that the work we do has positively impacted our clients and that they are happy to share their experiences.
Cogneesol transformed our claims process by making it intuitive and extremely customer centric. Our claims submission process is simpler now, with customers easily filling in forms. Further, the claims payment process has been shortened and simplified, thereby enabling quicker disbursal of the claims. Thank You, team Cogneesol, for these valuable structural changes!
It is always important to work with domain experts for critical functions. Our claims management function is one such critical department. We have Cogneesol handling the entire department for us for many years now. The technical expertise they bring to the operations has been ensuring the smooth functioning of every process and their complete compliance.
Our customer satisfaction score has gone up many notches from the time Cogneesol took over our claims management process. They have streamlined the activities making them simpler and quicker. A standard operating procedure was put in place so that service levels, accuracy and timelines could be met. These together have quickened the disbursal process, generating a great deal of goodwill.
