How Enlyte Is Bringing The Calm To Your Claim Chaos
With many new adjusters entering the workforce and experienced adjusters retiring or changing careers, organizations are looking for new ways to optimize their current processes. Adjusters are expected to quickly evaluate and turn around accurate demands which are complex and challenging to identify without structured data. This feeling of incomplete and inconsistent evaluations often can lead to poor settlement outcomes.
According to Enlyte’s 2022 Annual Trends Report, prior to 2020, less than 10% of the professional workforce worked from home all or most of the time, whereas now approximately 60% now work primarily from home. The move to remote positions brought unanticipated changes to how we live and work, substantially changing how our teams connect and get work done. This has been a significant shift in the claims adjusting environment.
As we continue to shift and learn how to manage some of these tasks from afar, insurance industries are trying to organize and simplify their teams' work processes, especially for these newly remote roles. When it comes to claims, it is hard for new adjusters to see the big picture in an easy, digestible way.
When things seem to be in chaos, it's often challenging to see how to stop, organize, fix, or see the light at the end of the tunnel. There are shows, videos, social media groups, books, blogs etc. teaching us how to organize—because the satisfaction of well-planned organization can have such a positive impact. Having things organized and easy for your team to see through the chaos can improve your claim outcomes and give employees a high sense of productivity, a win-win for all.
Let’s take a current case scenario. An adjuster can have over 100 open cases at any given time, depending on the nature and size of the company. They receive a new demand package with more than 150 pages they need to organize. They then need to review the various types of information and make decisions - do they need a nurse review, have all the correct billing codes, are the billed amounts unreasonable warranting fee schedule and network discounts, is negotiation needed? Even an adjuster with years of experience can still find this task daunting and overwhelming given the rest of their caseload.
Enlyte’s Third Party Adjuster Workspace provides this a convenient place for adjusters to organize all of their third party claim tasks - whether big or small. We help your adjusters get a full picture of the injury and treatments related to a claim. This liability-claims specific application provides adjusters an evolving picture of a claim as it develops and offers seamless integration with other solutions. Having easy-to-use technology allows adjusters to be able to see through the chaos and make the right choices
Our robust Adjuster Workspace gives your adjusters one place to manage their claims and makes it easier for them to submit requests and manage tasks, including:
- Code Review
- Nurse Review
- Peer Review
- Negotiation Services
- Bill Review
- Networks
This full visibility into a claim will not only help settle claims appropriately, it also coaches and trains your adjusters, resulting in outcomes they can feel confident about.
How your claims organization manages adapting to technology tools, while maintaining human interaction in a digital environment, will be key to optimizing results. With technical expertise and tenure continuing to decrease, automation and analytics will be the help senior adjusters with the time and insight they need to navigate the growing number of complex claims susceptible to runaway verdicts.
At the end of the day, the goal of an adjuster is to satisfy all parties involved with a fair settlement. Schedule a call to learn how our Adjuster Workspace can help turn chaos into simpler workflows, enable smarter decisions, and result in brighter outcomes.