Insurance Digitalization & Legacy Modernization
With advanced technology at their fingertips, Policyholders want direct interaction through multiple channels (e.g., direct, online, mobile) to submit, review, customize, purchase, and change products and services. But in many cases, Insurer’s legacy systems and processes undermine self-service and end-to-end customer relationship management.
BizFlow works with Insurers to enable direct, streamlined, and automated operations and communications though all stages of acquisition (i.e., new business, underwriting, customer service, claims) and administration. Contact us to learn more and schedule a demonstration.
- Sales & New Business - Preparation of proposal, review and approval by underwriting, preparation and sign-off of documents, system set-up, enrollment, billing, dispatch of policy kits
- Underwriting & Policy Maintenance - Proposal review, approval, reinsurance review, update, counteroffer, enrollment, termination, endorsement, claims intimation, change request, billing, collections, and commissions
- Customer Service (Email, Walk-in, In Bound Calls, Call Back) - Intake (review, validation, and categorization), distribution, adjudication, collaboration/communications (request/response), completion, survey, reporting
- Claims (Cash, Credit Life, Life, PA, PPO, Pre-Approval) Triage (validate data and documentation to trigger claim), intake (review, validation, and categorization), distribution (manual and/or straight through processing), adjudicate, posting and payment issuance, dispatch, resubmission and reprocessing, pending follow-up, reinstatement, status updates, quality assurance
- Straight Through Processing (STP) - Policy checklist to print and send packages, Letter templates to manage correspondence, Role manager to manage users, Case manager to manage case load, QA manager to ensure compliance
- Improve Net Promoter Score through streamlined operations and richer customer experience
- Automate distribution logic for work assignment based on established expertise and skill-sets with flexibility for special case management
- Automate metric collection, including time, department, work allocation, and work load, enabling accurate end-to-end visibility of KPIs without time-consuming data collection and estimation
- Enable free flowing collaboration among all participants to ensure proper and timeline communications
Logic (WDL) Manager
QA Manager View
Efficient & Compliant Patient-Focused Healthcare
Healthcare is facing a rapid change in patient and provider expectations. Members and their support network (hospitals, insurers, physicians, family) need to be in constant collaboration to schedule and provide care.
- Identify and prioritize service improvement initiatives in the context of changing delivery requirements
- Align operational objectives (increase revenues, assure accreditation) to clear metrics and business rules to properly
- streamline processes (revenue cycle management, HR)
- Capture and organize data to enable informatics to examine client needs and to support continuous process improvement
- Streamline application and change requests while standardizing operations for improved efficiency and effectiveness
- Measure business outcomes (patient volume/throughput)
Logic (WDL) Manager
QA Manager View
Leading Digital Innovation for the Government
The digital culture revolution demands that Government agencies get online and collaborate. Leaders must find ways to open and modernize systems while creating innovative and informative user experiences.
More than 400,000 Civilian, Defense, and Intelligence Community professionals work with BizFlow everyday to create and execute transformational strategies and solutions that improve operational efficiency, citizen services, and regulatory compliance. Whether procurement, task management, human resource management, grant management, or permit, we have helped agencies do it better, faster, and cheaper.
- Strategize programs for automation based on a clear understanding of priorities, benefits, and quick wins
- Facilitate digital experimentation with fast, simple pilot programs
- Go mobile to support multi-channel government services
- Get access to rich data for analytics and continuous process improvement
- Do more with less through automation and optimization
BizFlow BPM Suite can be used to create tailored solutions that meet your business process management objectives. BPM solutions innately enable users to initiate workflows, access actions/tasks assigned to them, monitor work in progress, track key performance, run reports, and make changes for continuous process improvement. Customers use BizFlow BPM software today for transforming and automating processes related to Human Resources, Finance, IT, Operations, Compliance, Marketing and Legal functions. In addition to the numerous administrative types of processes our customers automate everyday, our clients also benefit from solutions specific to their industry.
- Financial Services: Customer Enrollment / New Business, Claims Management, Customer Services, and Account Servicing
- Manufacturing: New Product Development Lifecycle Management, Sample/Engineering Order Processing, ISO 9000 Compliance, and Contractor and Vendor Management
- Higher Education: Curriculum Change Management, Graduation Exceptions, Gift Acceptance, Policy Management, Action Tracking, and Loan Management
- Energy: OSHA Compliance, NERC/FERC Compliance, Change Management, Process Safety Management, Incident Investigations, Customer Care, and Inspections