Healthe recently published a new featured article on WorkCompWire, which explores the importance of improving claims professionals’ digital experience to improve claims outcomes. The following content appears online at WorkCompWire.
Claims professionals have long been the frontline of claims management – this has not changed. What has changed is just about everything else.
Claims continue to grow in complexity – and therefore have become more complex to manage. The claims workforce is changing, too.
As we continue to try to attract talent to the industry, the bar becomes higher for what these new professionals expect. Better tools and a better experience. Humans are becoming increasingly hardwired for digital preferences and interactions. And with reason – with the right tools, there are tremendous efficiencies to be gained over historical methods. (Dozens of phone calls in a day? Let’s all pause for a reminiscent chuckle.)
And even as the tools and workflows employed to facilitate claims professionals’ jobs become increasingly more sophisticated – the tools themselves cannot appear more complex. The bar is set at nothing short of a streamlined, easy to use, one-stop experience.
It’s a big ask, but one that we’re driven to continually find new answers for. Here are five ways Healthe is leveraging technology, analytics, and insight to enhance claims professionals’ digital experience.
#1. Focus on the “Human” in Human-Computer Interaction
Part and parcel with technological design is the human element. How is the end user going to feel using the tool? What value are they going to derive from it?
When designing solutions meant to assist claims professionals, we start – and finish – by asking the prospective users what they think and what they need from these tools. These frontline users know just how many ways things can go wrong, or how often they run into the same hiccups in the claims process.
When captured effectively, claims professional insights can inform innovation in ways that improve productivity, deliver more informed interactions with injured workers, and make the process of claims management easier and more effective – while also improving claims staff satisfaction.
Here is where user research and user validation studies become valuable tools for understanding stakeholder preferences and pain points that can inform program enhancements and new services that meet the unique needs of different users – whether the day-to-day claims examiner, the nurse case manager, or claims leadership.
#2. Prioritize Visibility into Claim Information
Having the right information at their fingertips, at the time it is needed, is crucial to helping claims examiners make timely decisions that move a claim forward.
Effective information architecture brings greater visibility to important information across the claim lifecycle, while also removing the clutter. And an informed approach to information architecture includes applying research and data, including data on user behaviors within systems.
Research data helps to identify areas where visibility is lacking, prioritize the most and least valuable data elements that examiners wish to see in their claim tools, and ultimately creates an intuitive digital experience that includes step-by-step workflows and prepopulated data elements.
This ease-of-access and self-service visibility into key information has become even more important post-pandemic, where claims organizations continue to employ a remote workforce, reducing person-to-person interaction as a resource for claims examiners to help answer questions and troubleshoot problems.
Visit WorkCompWire to continue reading the article, which explores aligning technology preferences and needs, incorporating intelligent automation, and letting analytics drive claim and program management.
