Solutions: Salesforce.com for Health Insurer

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Purpose

The overall goal of the project was to automate business functions, reduce cycle time, and provide accurate reporting by upgrading the current technology suite.


Process

We are building a Salesforce.com platform for an Insurer in the payer domain for their large and custom group portfolio. This is to establish a solid Case Installation process and system to accomplish the defined goals.

Several Business units like Sales, Marketing, Benefits, Pharmacy and many downstream systems utilize the process and technology to install a case for the Large and National Accounts that offer insurance to their employees. e.g American Airlines.

By automating the paperwork and the ability to accurately record the customer requirements, the client is trying to achieve a process and system to be able to meet the needs of the customer for the year-end enrollment and not delay the ID cards or the summary of benefits booklets and be ready to service by the effective date.

It is important to have the installations complete by 01/01 where the majority of the accounts get renewed or new accounts are established so the customer’s employees have all the information for their account and can visit a doctor.

By automating the paperwork and recording all the information digitally, errors are caught at the beginning of the process and can save thousands of dollars in false claims.

 

1.     Selection of a tool for the case installation.  After rigorous selection methods and the customer needs, Salesforce was selected and implemented.

2.     Re-engineering the Business Process to meet the client expectations.

3.     Automating the Salesforce to Membership & ID Card Systems

 

Overall responsibilities as an IT lead, delivered IT Road Maps derived from the needs and provided business and technical direction for all the phases of SDLC and reported weekly on the status of them.


Results

Improved accuracy of paperwork, reduced cycle time, enhanced reporting framework, on time delivery of ID Cards.

 

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