Handling Claims with Ease: 7 Breakthrough Benefits of Claims Management Software


Many industries have leveraged technology to improve efficiency—and, therefore, their bottom lines—yet claims operations seem stuck in the slow lane. Automated claims management software changes that.

The key to improving efficiency is streamlining workflows. Well-crafted workflows transform the entire claims operation. With claims automation, every facet of the operation can reap the benefits.

Today, customers aren’t just looking for decent service; they expect excellence. With claims automation software, insurance companies can deliver 5-star customer service with greater ease and speed.

Technology can enhance the claims management process from A to Z. The benefits will impact Claims specialists, insurance companies, and customers alike. Learn how automation works to produce the following seven groundbreaking benefits.

1. Bringing Modern-Day Speed and Efficiency

Automated claims management software weaves through every part of the system to put smart workflows in place to speed up claims processing and increase overall efficiency.

Automation eliminates the problem of employees “doing their own thing” by empowering insurance companies to embed best practices directly into their workflows. As needs change, automation makes customizing workflows a snap. Armed with input from key players, insurance companies can switch things up and solve problems faster with a minimum of effort.

Automation eliminates many tedious, manual tasks, leaving workers free to tackle the more complex aspects of their roles. The result is improved overall efficiency. Greater efficiency lends itself to faster claims management.

2. Enhancing Accuracy and Minimizing Errors

Experian Health tells us that human errors are common – that is, without the benefit of claims automation. Mistakes hold up claim checks, causing customer frustration and an increased workload when they complain.

Automated claims software automatically verifies data with databases inside and outside the company. Underwriters will welcome having a treasure trove of data. Data is critical to accuracy and making informed decisions.

Claims management software automatically spots anomalies and errors. Red flags fly up early in the process when a claim needs a human touch.

For example, the software can cross-check names, addresses, claim payouts, and other data. All workers view the same information. This way, no part of the system loses or misconstrues data.

Unlike human workers, software does not get tired or distracted. That means data is always accurate and consistent across all parts of the system.

3. Ensuring a Good Customer Experience

A McKinsey report states that Millennials and Gen Z demand excellent customer service. They expect to be able to chat about their claim on the nearest device. Email, chat, text, and phone are the communication channels of choice. When they are in the mood, they want to talk to a real person rather than wait on hold while a bot passes on their question to an agent. Seamless interactions are what it’s all about.

Communication should work efficiently both ways; with automation, it does. Claims software helps fill in any communication gaps.

Imagine a world where claims specialists enter data smoothly from one field to another. Data then zips from one system to the next within seconds. Customers will not be frustrated by answering the same questions multiple times. Claims workers will not have to re-enter their answers, either.

By the time a claim gets to underwriting, underwriters have complete information, allowing them to make quick decisions. Fast claim settlements make for happy customers.

4. Maximizing Cost Efficiency

Automation is cutting-edge technology that detects fraud to cut operational costs.

Modern claims technology works behind the scenes, automatically assigning and prioritizing tasks. It yields valuable data managers can use to ensure the right task gets to the right team member.

Claims management software analyzes massive amounts of data and produces reports quickly. Suspicious patterns let insurers take action on fraud – fast!

AI tools are embedded into the software. They pick up details like names, addresses, and dollar amounts that could raise a red flag of fraudulent activity.

Fewer fraudulent claims save insurance companies money. The Coalition Against Insurance Fraud reports that insurance fraud costs the United States over $308 billion annually. How great would it be to pass those savings on to customers?

5. Improving Compliance and Reporting

Auditing can be a nightmare for insurers. Automation software makes it a dream by producing accurate reports and streamlining the entire process. Insurance companies will no longer dread the annual audit.

Governments regulate insurance companies heavily. They have to protect the public. Claims management software flags claims when insurance companies must adhere to laws.

In short, automation software casts worries over compliance to the side.

6. Leveraging Scalability and Adaptability

Claims management software works in a cloud-based environment. Scalability and adaptability are significant advantages of cloud technology. The software allows insurance companies to easily scale their resources up or down as their claim volume changes.

Unfortunately, legacy systems do not always play well with digitization. Hard drives make it challenging, if not impossible, to customize workflows. Also, making challenging configurations costs more and wastes valuable time.

Insurance companies have historically been slugs with digital transformation. Claims automation software has changed the game. Insurance claims software sets insurers on pace to compete with the best.

When insurance companies must add, change, or delete capabilities, claims management software programs make it happen without frustration.

7. Unlocking Analytics and Insights

Embedded AI and advanced analytics capabilities are nothing less than a technical marvel. Users can pull targeted reports to shed light on data that allows them to address their specific pain points.

Predictive analytics uncover risk data from third parties and combine it with internal data. Risk managers gain access to all the risk data at once, making them masters of risk assessment. This is a faster, more accurate way to conduct risk assessments compared with manual methods.

Claims management software lays the flaws of legacy systems bare, shining a light on how workflows can improve. A modern system also yields metrics workers can use to evaluate the newly created workflows. From there, companies can fine-tune their processes even more.

Automated Claims Solutions: Reaping the Benefits

Automated claims solutions not only streamline workflows but are also fast and easy to implement. Employees can be up and running on the new system in short order. With so many benefits, delaying adoption is a cost that insurance companies can no longer afford.

As a recap, leveraging automated claims management software will reap the following seven benefits:

  1. Efficiency and speed
  2. Accuracy and error reduction
  3. Enhanced customer experience
  4. Cost savings
  5. Compliance and reporting
  6. Scalability and adaptability
  7. Analytics and insights

Data collection is a critical part of claims processing. Claims specialists spend countless hours analyzing data and performing needless tasks without automation.

Automation helps insurers keep up with the ever-evolving landscape within the insurance industry. It is the key to leading the pack. Modern claims technology is nothing short of essential for insurance companies.

Learn more about how to reap the benefits of automated claims software and get your claims department running more smoothly today. Request a demo with Five Sigma.

Article Sources:

Nguyen, K. (2023b) 7 reasons for claims errors and how to avoid them, Healthcare Blog. Available at: https://www.experian.com/blogs/healthcare/7-reasons-for-claims-errors-and-how-to-avoid-them/ (Accessed: 10 January 2024).
Coalition Against Insurance Fraud. (2022). Retrieved from https://insurancefraud.org/wp-content/uploads/The-Impact-of-Insurance-Fraud-on-the-U.S.-Economy-Report-2022-8.26.2022.pdf (Accessed: 10 January 2024).
Experian Health. (2022, July 20). 7 Reasons for Claims Errors and How to Avoid Them. Retrieved from Experian Health: https://www.experian.com/blogs/healthcare/7-reasons-for-claims-errors-and-how-to-avoid-them/ (Accessed: 10 January 2024).

Five Sigma - AI-Native Claims Management Platform

Five Sigma offers an AI-native claims management platform that streamlines every step of the claims process. With full visibility of the claim at a single place, advanced automation, and data-driven insights, Five Sigma empowers adjusters to excel, speeding up claims handling and improving policyholder satisfaction. Adjusters are freed to focus on decision-making and customer service. 

For insurers, MGAs and TPAs, Five Sigma is a risk-free solution that unlocks unprecedented benefits quickly. Insurers gain unparalleled visibility into their claims and operations. The result is a significant reduction in Loss Adjustment Expenses. Five Sigma is a future-proof platform that is always up to date for the benefit of all its customers and gives insurers the agility to handle any claim faster, add new Lines of Business in less than a day, and accommodate new business models easily, enabling you to adapt swiftly to market changes ahead of the competition.

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