Insurance Back Office Outsourcing

Outsourced Claims Processors review insurance claims submitted by individuals or businesses, verify the claims information indicated, calculate and process claims payments and determine the coverage and eligibility for claims based on policy terms and conditions. They can work for individuals or specialized industries such as insurance companies, healthcare providers, and customers to ensure timely and accurate claims processing.

They communicate with insurance companies, healthcare providers, and customers to obtain necessary information and resolve claim issues. They also maintain accurate records of claims information and transactions and ensure compliance with regulatory requirements and guidelines.

Underwriting support specialists are responsible with managing high volume insurance applications. They properly evaluate insurance applications, determine the level of risks involved, and approve or deny insurance coverages. By outsourcing the underwriting process to a trusted BPO provider, companies save time and resources while maintaining the accuracy and quality of underwriting functions.

Policy administrators manage the administration and maintenance of insurance policies, from managing policies from start to finish, including policy setup, underwriting, to ssuing. They can also assist with policy changes, updates, and renewals, make sure clients receive updates on their policy changes by informing them, answering policy-related queries, and properly documenting these updates.

Businesses can delegate the first point of contact of customers to customer service outsourcing specialists to manage both outbound and inbound phone calls, and other functions such as answering customers’ claim status updates, premium payments, and general insurance-related queries, and helping policy holders with policy information.

Data entry operators are responsible for accurately entering and updating data into insurance systems. They input policy details, claims information, customer data, and other relevant information into the designated databases or software.

Quality Assurance Analysts is a professional who ensure operations meet the required performance standards, identify areas for improvement, and ensure compliance with industry standards. They ensure efficiency and accuracy by providing process such as recording metrics, checklists, and so on regarding issues encountered in the insurance back office process.

Back-office support staff perform various administrative tasks that support the insurance back office operations. This may include document management, file organization, record keeping, generating reports, and other administrative duties.

Team leaders provide overall support to their team members. They are responsible in overseeing and monitoring the day-to-day functions and daily operations of the team. They therefore need to have the ability to identify objectives, problems, analyze and interpret data, draw valid conclusions, and make sound decisions.

These professionals have in-depth knowledge of insurance processes, rules, regulations, and best practices. They analyze the client’s requirements, design process workflows, and ensure that the outsourced processes align with industry standards.