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Predictive Analytics and Automation – The Future of Claims Management is Now

Leveraging your data means you can improve efficiency, cut costs, and increase customer satisfaction. You just need to know how to get started. 

Technology is rapidly changing claims management with benefits that include improved efficiency, error and cost reduction, and boosted customer satisfaction levels. Two of the most potent and trending tools are predictive analytics and automation. 

Predictive analytics tools use historical internal and external data to forecast possible scenarios and drive strategic as well as everyday business decisions. Automation uses data extraction technology to review and analyze the documents used in claims management. It also speeds up resolution through the use of electronic, rather than paper, documents. 

Claims management must go digital to remain competitive. Automation and predictive analytics has brought efficiency and accuracy as well as reduced costs, and this article takes a deeper look at both and their benefits. We’ll also discuss implementation challenges and how they can be overcome. 

The beauty and benefits of predictive analytics

Predictive analytics means mining multiple data sources to identify hidden trends, then using these patterns to construct models for accurate forecasting. Even the most experienced adjustor can benefit by making decisions that are data-driven, timely, and accurate, and that benefits the entire company.

Predictive analytics can help you drive optimal outcomes because you can:

  • Prioritize claims
    Claims are automatically classified, helping you mitigate severity through rapid identification of the most costly and complex claims.
  • More accurately set case reserves
    Accurate reserves are vital to your company’s financial security, and the responsibility for setting these often lies with an individual adjuster. Multiple data sources provide insights that can then be leveraged to confidently set reserves.
  • Rank risk and severity
    Claims have to be handled by a person with the right level of experience to both mitigate costs and settle claims efficiently from the outset. Risk ranking and severity scoring mean the right adjuster gets the right claim, optimizing resources.
  • Automate workflows
    Predictive analytics automates the process of information gathering and analysis and provides real-time updates and alerts. This means adjusters can focus on higher-value tasks but still have a transparent view of claim status.
  • Predict “jumper” claims
    Sometimes, claims can “jump” at about the three-month mark to become a high-cost claim needing close management, a higher reserve, and additional resources. These claims can be identified early so you can take preventative action.
  • Avoid litigation
    Predictive analytics means you can easily identify claims that will probably result in litigation to try to settle at an early stage. The process can also estimate the associated legal fees that come with defending a claim and how long the proceedings will last. 
  • Estimate settlement and fraud
    Analytics provide real-time, objective insights, so you don’t have to rely on your intuition based on the limited amount of information available. 

In a nutshell, predictive analytics mean you can better understand historical trends and improve performance by integrating multiple third-party data sources. These sources span various industries and claim types to create benchmarks to compare how your organization is doing against the competition. 

Automation is about more than efficiency

Operational efficiency gets a big boost from automation, plus lowers costs, streamlines settlements, and cuts processing time. You can automate everything from case opening to assignments to scheduling, but its most important function is perhaps that automation creates the system-to-system connections to integrate data. 

Automation also:

  • Takes on repetitive manual tasks to ensure resource optimization
  • Minimizes costly data errors
  • Speeds claims processing
  • Increases employee satisfaction
  • Provides lasting value with its ability to scale up

It boosts efficiency while also resulting in higher customer satisfaction in an area that is a leading cause of customer frustration. Customers want frequent, accurate communication, and automation means you’ll have the data you need at your fingertips to manage their expectations.

The challenges in implementing predictive analytics and automation

The benefits of applying predictive analysis are huge, but the process is not without its challenges. Let’s explore a couple of the issues and solutions that you might encounter:

Challenge 1: Data quality and availability

Data quality measures accuracy, consistency, reliability, completeness, and timeliness. This is where errors can be found and assessments made to judge if data is fit for purpose. Poor-quality data can create nightmares for adjusters, increase expenses, skew analytics, and mar overall business strategies. 

Data availability, meanwhile, refers to how available your business-related data is to end users whenever and wherever they need it. Poor data quality and siloed storage impact availability, as do other factors. 

Solution 1: Data cleaning, standardization, and the right technical infrastructure

The correct technical infrastructure allows you to integrate even legacy systems, implement automation and predictive analytics, and run a better, more profitable business. Data cleaning involves correcting or removing corrupted data as well as any that is improperly formatted, duplicated, or incomplete. This task multiplies with siloed data, which is why it is essential to integrate your internal and third-party data into one system.

Data that is scattered among disparate systems is inefficient and creates opportunities for inaccurate or duplicated information. Data sets are getting larger by the day, too, so it’s inefficient and impossible to manually scrub your data. 

Challenge 2: Employees

It’s human nature to resist or fear change, which is often seen as a threat to both stability and predictability in the workplace. Some long-term employees may have done things the same way for a decade or more, so adding new technology may cause anxiety. Some may fear the unknown or think they will be replaced by technology.

Solution 2: Strategies that decrease resistance

It’s time to empathize and sympathize, and present your exciting new technology changes in the best light possible. To that end:

  • Communicate
    This can’t be overemphasized. Talk about how your new technology will work, let them know it will free up time for more important tasks, and be sure to solicit and listen to feedback.
  • Encourage participation
    Ask employees to take part in implementation and discuss how best to introduce innovations. They will then feel they are part of the effort and can make a contribution that counts.
  • Educate and provide resources
    Prepare your employees in advance with training classes and documentation, and be sure to offer a demo if one is available.

Inspire your employees. It’s your new technology that includes predictive analytics and automation that will make that dent in your case management universe with streamlined operations, speedier resolution, data that spurs business growth, and happier customers. 

Get help boosting your productivity and profitability

Claims management is undergoing a revolution, and the future is here with predictive analytics and automation. Embrace innovation and gain a competitive edge with Susco Solutions. We make your business more efficient, boost your workflow, close operational gaps, and help you communicate effectively both internally and externally. Get faster, better, stronger, and boost revenue.

For more than a decade, our dedicated team of web and application developers has built custom solutions that perfectly align with business goals. Get in touch today so we can schedule your free one-hour assessment.

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