Enterprise Claims Management

Our client is a law firm based out of the United States that specializes in the compensation claims of employers, insurance carriers, and third-party administrators who have been defending workers’ compensation claims since 1991. They also deal with willful misconduct claims for their clients and employ tech-savvy lawyers who can connect with clients through web-enabled practices. They specialize in defending fraudulent claims and have an unparalleled track record of success.

The claim management system that the client was using involved paper files, manual processes, and multiple systems. This process was resource-intensive and consumed much time as well. This disrupted their ability to handle each client’s claim efficiently and on time. Due to a lack of standard processes for claims handling, there was very little transparency in the enterprise claims management process. The client realized their traditional systems had become obsolete, leading to ineffective communication and collaboration. This negatively impacted their efforts to remain competitive in the market.

The first step of the solution was to understand the problems and pain points that the client was facing with their existing claims management process. Our team visited the client at their US headquarters and collaborated with them to understand the issues better. After analyzing the inputs and business objectives, our team created an action plan and strategic roadmap for a comprehensive claims management platform. We adopted a multiphase engagement where modules were developed and tested in phases.

The first phase involved creating a billing module for the client. In the existing solution, the client had to pay a large user license fee, demanding a lot of time and effort from the attorneys. The new billing module streamlined processes like calculating billing charges, automatic invoice sending, and accepting recurring payments.

The second phase involved the development of a document-scanning solution that would replace their existing third-party software. Employees use this solution to scan and organize their case documents, bills, reports, case sheets, and other documents digitally. This method saved space, made the data secure, and could be shared easily.

In the third phase, the team worked on a case management solution. With this, employees create, track, and assign cases seamlessly. Processes for each case can be defined clearly, and users can easily complete a case by following all the necessary steps. Once a case is finished, the solution will show how to categorize the cases, which process to follow, case status, and more.

Experion also plans to deliver a web-based worker’s compensation claims management platform after enterprise digital transformation. This would integrate with the enterprise claims management process and enable them to leave a lasting mark on the insurance marketplace.

• Streamlined the entire claims compensation process so that it took less time and was more accurate
• Helped in enhancing the overall customer experience as their claims were getting processed faster
• Offers intelligent reporting and analytics to provide useful insights that enable superior operational and business efficiency
• An improvement in the time taken for processing claims leads to a reduction in the cost of claims processing