Claim organizations face a significant task in today’s environment. The escalating cost of claims continues to be a major concern. From timely incident reporting to claim accuracy, excessive administrative costs, and more, organizations need to adopt strategies to reduce costs and build an efficient and sustainable claim system.
Advances in technology can provide the answer: tools to automate processes, reduce costs, and ensure an efficient, results-driven claims operation in a changing environment. While the problems are often complex and multifaceted, technological innovation is drastically improving how claim organizations manage claim administration.
PRIORITY 1: Adjusting for less experience, higher caseloads
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While technology is rapidly reshaping the industry, one of the biggest concerns faced by claim organizations is managing a changing workforce. With constant pressure to improve profits and reduce costs, claim organizations are looking for savings by hiring less-experienced adjusters. This trend results in adjusters with less industry knowledge, less long-term commitment, and limited experience in the use of existing tools.
Companies need to ensure new hires are capable of handling claims with as little disruption as possible. If not properly mitigated, employee changes can cause a major disconnect in the efficiency and quality of a claims operation.
There are challenges even for an organization’s experienced adjusters. Not too long ago, the typical caseload for an adjuster was around 65 to 80 open claims. Now, it’s common for an adjuster to have 125 to 150 open claims in their caseload.
So, the question for claim organizations is, How can they maximize efficiency, reduce costs, and improve output? The answer lies in smart technology like robotic process automation (RPA), which is described on the next page.
Technology that automates processes and workflows can help bridge the gap in experience as well as increasing workflows:
- For less-experienced adjusters, claims administration systems cut down on time required for employees to acclimate to procedures, increase consistency in which claims practices are utilized, meet compliance, and ensure a smooth transition from one claims handler to the next.
- For an organization’s more-experienced adjusters, capabilities like workflow and document automation are critical to handling an increased caseload.
PRIORITY 2: Ease of Use
Claim administrators need software that is easy to learn, intuitive to use, and effective in end-results. New adjusters are entering the workforce, and while lacking experience, are much more technologically inclined than previous generations. Modern software can, therefore, be adopted quickly, resulting in minimal training without compromising claim accuracy or efficiency.
Ventiv’s iVOS 5 software, for example, is designed specifically to deliver a logical workflow through an updated and configurable interface that allows access to claims through multiple browsers, operating systems, and devices (mobile, tablet, and desktop). An integrated dragand- drop dashboard consolidates data into one location to enable a new level of customization designed to meet each client’s specific needs.
PRIORITY 3: Automation, Workflows, and Management
In this traditionally labor-intensive operation, technology has enabled claim organizations to achieve a higher level of output with less manual interaction throughout the life of a claim. Claim operations should expect a high level of automation from any claims-administration system they consider.
Simply put, automation allows companies and workers to remove the now unnecessary groundwork and focus on more important tasks. To take Ventiv’s iVOS 5 as an example, an updated client-determined schema enables claim organizations to build their own workflow rules, which significantly reduces the cost of claims handling without compromising high service and quality levels.
Technology can also automate non-core administrative tasks that do not impact the quality of a claim. A claims-administration system should allow users to send/ schedule emails, create diaries, trigger alerts and notifications, set reserves and more: all while ensuring strict criteria are met, and strict compliance regulations have been followed.
PRIORITY 4: Operational Efficiency
Improving operational efficiency is a key aspect of any claim organization. While many have embraced the digital age, there are still organizations that have a deeply ingrained reliance on paper.
The impediment for change goes beyond financial considerations and can be tied to the intrinsic value of a physical document. Paper can feel safer, and organizations are comfortable operating in a known environment. However, as times change, paper-based processes can deliver a weakened claims infrastructure with limited transparency, predictability, and ultimately, a lack of efficiency across the board.
Document-management tools make it possible to package claim files in the click of a button, upload hundreds of documents at different stages along the workflow, easily locate files from anywhere, and share documents effortlessly.
Possibilities for improving efficiency extend to how incidents and events are captured in the field, the data fed into the claims-administration system, and then made available to adjusters. As claim organizations know, one of the keys to closing claims faster is shortening the lag time between when an incident is reported and when the adjuster begins administering the claim.
Claim organizations should look for intake tools that are usable across all platforms, browsers, and operating systems. They should also look for intake tools that have their own dedicated mobile apps. The latest generation of intake tools. Ventiv’s Capture solution, for example, features seamless integration with iVOS 5. With full support for desktop and mobile apps, Capture makes field events and requests immediately available for reporting, analytics, and action as necessary.