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Modernizing Claim Systems for Organizational Efficiency

Managing claims is a high-level skill that includes containing costs and effectively analyzing claim information while providing an optimal customer experience. Claim adjusters not only need a controlled system in place, but also need key features for optimal organizational efficiency.

Author: Jdidata.com
Date: Dec 5, 2012 - 6:19:10 AM

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Managing claims is a high-level skill that includes containing costs and effectively analyzing claim information while providing an optimal customer experience. Claim adjusters not only need a controlled system in place, but also need key features for optimal organizational efficiency.

The advancement of the insurance technology industry now puts the power in the adjusters’ hands. When choosing a claims software system adjusters can now define exactly what their needs are, how the system is used, who is interfacing with data, and the list can go on and on.

In a perfect world the ideal claims processing system assists adjusters with not only making better decisions, but also doing business smarter with the enhanced tools to see the bigger picture. The definition of an ideal claims management system can vary from one adjuster to the next. A few top priority features include:

Simplicity - A multi-line adjuster in today's world needs a very minimal learning curve. Training an adjuster on a new system should be intuitive. Claims are all worked in several different ways, depending on the adjusters’ workflow process. Giving claims adjusters and manager the option of an intuitive interface with simplicity is a must.

Flexibility – Having an agile claims system that easily allows system enhancements and upgrades is ideal for claims adjusters. Having the ability to change system business rules without involving help from the IT department is essential to a high performing claims system.

Policy Administration Integration – Claim systems that integrate with policy administration, billing, and payment services equip adjusters with the support needed to cover verification and payment disbursements. Having a one system claims management solution is key to providing insurance carriers opportunities to increase business growth and advance operational efficiency.

Claims executives are aggressively spearheading the mission to not only properly address consumers’ needs but also enhance the ever evolving claims workflow process. As new business rules are put into place and business processes are updated having a claims system that can grow with them empowers the adjusters in the decision making process.

It’s no secret that claims administration systems are aging. With claimant behavior constantly changing, insurance claim management system goals should be to provide clients with a more efficient system that in turns helps with error elimination, fraud detection, and balance their lost costs. As claim solutions modernize their system keeping integrated workflow and process management in mind will give adjusters’ a renewed interest in replacing legacy systems.

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.

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