Insurance - Risk and Compliance

Risk and Compliance

Successful insurance industry organizations control risk using the latest approaches and technologies. By eliminating errors and fraud in claims payments, automating the risk management process, or adjusting the business’s reporting strategy in response to external factors, Prolifics can help your organization develop and execute a risk management plan that balances risk, costs, and compliance.

How We Help

Prolifics works with insurance enterprises to support risk and compliance initiatives, including…

Risk and Compliance Case Study

HIPAA-Compliant Insurer

Prolifics provides a health insurer with visibility and control across HIPAA transactions to speed up claims processing, increase compliance and secure sensitive information.

 

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Prolifics' Capabilities

Improper Claims Payments >> 

Making the right payments at the right time is key...

Making the right payments at the right time is key to business success. Overpayments, as well as premature or late claims payments, create substantial unnecessary costs. Whether these payment problems are due to legitimate errors or because of fraud, eliminating these problems can enhance customer satisfaction and bring greater stability to your bottom line.

Prolifics leverages the latest technologies to help minimize the errors and fraud that arise as part of the claims process. Decision management, business process management, and Cognitive-powered artificial intelligence assist in streamlining business operations and gaining insight into attempted fraud.

Risk Management Automation >> 

Business excellence is rooted in the accuracy and security...

Business excellence is rooted in the accuracy and security of operational decisions. The rules and requirements surrounding risk management are becoming increasingly complex. In response to this, enterprises are automating compliance, decision-making, and customer experience measures. This helps minimize the risks that arise from the involvement of human employees in critical business processes such as account management and customer verification.

Prolifics helps implement business process management and robotic process automation throughout your business to automate core processes, enhancing security, reporting, and risk administration.

Enhanced Reporting >> 

Reporting is a time, cost, and effort-intensive process...

Reporting is a time, cost, and effort-intensive process—particularly so when insurance organizations are involved. It is imperative for enterprises to reduce the margin of error present in reporting and accounting, providing the most accurate results possible to decision makers, leaders, auditors and regulators.

Prolifics introduces solutions to improve reporting while reducing associated costs. We help you capture necessary data and apply robotic process automation to automate reporting activities like validation and reconciliation. We also leverage business process management and decision management to produce the insight and understanding of the business that effective reporting requires.

Adjusting to the Regulatory Landscape >> 

The regulatory climate is in constant flux. The insurance industry is especially subject...

The regulatory climate is in constant flux. The insurance industry is especially subject to these changes—with high amounts of sensitive and financial data involved, it is imperative that enterprises remain in compliance with these regulations even as they change. With the right partner on your side, your business can navigate the shifts in the regulatory landscape that correspond to changes in the political environment and the business climate.

Prolifics helps enterprises bring their reporting strategies up to date and lay the foundation for the future. Our experts guide you in building real-time reporting solutions contracted on a backbone of automation and better business process management.

Security >> 

The sensitive nature of insurance data requires a comprehensive security approach.

The sensitive nature of insurance data requires a comprehensive security approach. To keep the enterprise safe from end to end, insurers require optimized digital security controls that monitor threats in real time and leverage analytics to prioritize and manage issues.

Prolifics implements solutions that control access to key assets and protect your business from potential breaches. We help augment your security intelligence with analytics, implement data defense technologies, manage access using measures like multi-factor authentication, and adhere to critical security regulations like the GDPR.

Technology Makes it Possible

Prolifics' expertise across multiple specialties enables us to create unique, comprehensive solutions for innovative cost optimization. Technologies we typically leverage for these types of initiatives include: