PAS Claims is a tailored claims management system designed specifically for insurance businesses to streamline and automate the processing of insurance claims. This custom solution simplifies claims workflows, financial calculations, invoicing, and email notifications, enabling efficient management of claim data and supplement calculations from a centralized, intuitive platform.
Role:
Designer and PM
Industry:
Insurance Restoration
Duration:
40 weeks
Scope
Brand Identity: Designing a visually appealing website that authentically reflects Aura Vault’s unique style and musical essence.
User Experience: Creating an intuitive interface that allows fans to easily access music, event information, and merchandise.
Fan Interaction: Implementing features that facilitate interaction between the band and their fans, such as personalized content, fan community forums, and social media integration.
My Approach
Discovery Phase
Client Consultation: Held detailed discussions with the insurance business to understand their needs for automating claims processes, payment estimations, invoicing, and workflow management.
Requirement Analysis: Identified essential features, including trigger-based automations, event-driven workflows, financial calculations, email automation, and role-based access control. Defined user roles for claims adjusters, managers, and administrators.
Design and Development
UI/UX Design: Designed an intuitive and efficient user interface to simplify claim processing, payment estimation, and reporting, ensuring quick adoption by adjusters and managers.
Custom System Development: Built a tailored claims management system with modules for workflow automation, payment calculation, invoicing, email notifications, and role-based access control. Ensured the system supported complex financial calculations and dynamic data handling.
Testing and Iteration
System Testing: Conducted rigorous testing with real-world claim data to validate the functionality of automated workflows, financial calculations, and email notifications. Ensured the accuracy of payment estimations and invoicing.
User Feedback: Engaged claims adjusters and managers to gather insights, addressing usability concerns and refining the system for optimal performance in real-world scenarios.
Launch and Ongoing Support
Deployment: Successfully deployed the claims management system, ensuring smooth operation of all automated workflows, financial processes, and integrations.
Post-Launch Support: Provided continuous support and updates, resolving issues, optimizing performance, and implementing additional features to meet evolving business needs.
Challenges
Complex Workflow Automation
Mapping and automating intricate, event-based workflows for insurance claims. The system needs to process various triggers and actions based on claim status, type, and other dynamic factors, making the workflows complex to design and implement.
Financial Calculations & Payment Estimations
Accurate calculation of payments and estimations based on diverse claim details. The system based on pre-defined items and rates to handle financial calculations and generate correct payment estimations, invoices, and supplements for different claim types.
Email Automation with Attachments & Variables
Automating personalized email notifications for various stages of the claim process (e.g., claim approval, payment processing) while dynamically inserting variables such as claim details, payment amounts, and attaching necessary documents (e.g., claim reports, invoices) for each recipient.
Role-Based Access Control (RBAC)
Implementing role-based access to ensure that different users (e.g., claims adjusters, contractors, and administrators) have the appropriate permissions. This involves ensuring users can only access data and features relevant to their roles while preventing unauthorized access to sensitive information.
Testing & Quality Assurance
Testing such a system is a significant challenge due to its complexity. Validating that all workflows, calculations, and integrations function properly under real-world scenarios, as well as ensuring accurate data processing, requires thorough testing across different claim types and data inputs.
