Insurance Audits & Policy Management SaaS CRM Platform
Timeline: 12 Months| Country: United States
Project Brief
This platform is a comprehensive CRM system designed by insurance professionals, for insurance companies. It’s a space where various users, including schedulers, auditors, billers, and carriers, can efficiently manage policies, audits, and billing workflows. Whether you're handling policy updates, scheduling audits, or managing billing inquiries, this system is designed to streamline complex tasks and ensure accuracy across all operations.
With a strong focus on automation and seamless integration, the system syncs policy data from carriers using advanced methods like PDF extraction, XML parsing, Gmail inbox reading, and SFTP server connectivity. This automated process ensures that policies are up-to-date, and auditors are assigned based on carrier operating hours and availability, simplifying the auditing process.
The platform also provides a suite of tools to manage billing, reporting, and query resolution. Invoices are automatically generated, and queries from carriers are routed to the scheduler for resolution, ensuring that the system works as a unified, efficient platform. With a strong focus on security and data integrity, the system also includes features like encryption, role-based access, and automated compliance to protect sensitive insurance data.
Client's Need
- The insurance company approached us with a challenge: their internal processes for managing policies, audits, and billing were fragmented and time-consuming. Each department, from auditors and schedulers to billers and reviewers, worked in silos, manually handling data and communication. This not only led to delays but also created room for errors in managing policies, auditing, and invoicing.
- What the client needed was a centralized SaaS CRM platform that could automate the entire process—from importing policies through PDF and XML extractions to streamlining the scheduling of auditors and ensuring timely billings. They also required seamless integrations with external systems, including Gmail and SFTP servers, to import data effortlessly. The goal was to create an efficient, unified system that would allow the team to easily manage policies, assign audits, generate invoices, and handle queries, all while reducing manual work and improving the overall workflow and accuracy.
- The ultimate goal was to create a unified system that automated policy management, auditor scheduling, and billing while safeguarding data privacy. The solution would ensure smooth workflows, and real-time reporting, and reduce manual errors, all while adhering to the highest security standards for handling sensitive data.
Technologies
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HTML 5
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CSS 3
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Angular JS
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PHP
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Laravel
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Python
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AWS, S3 Bucket
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Google APIs
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Google Maps API
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Calendar APIs
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Challenges
- Extracting policy information from Gmail attachments sent by auditors was a complex task due to varying formats and content within email attachments. Ensuring that all policies were accurately extracted and updated in the system posed a significant challenge.
- Auditors were required to handle audits in various locations, often with unpredictable scheduling. Designing a cost- and time-efficient route that accounted for auditor preferences, locations, and carrier requirements was a significant logistical challenge. Additionally, auditors needed a visual, interactive tool to draw and optimize routes between audit locations, which further complicated the scheduling process.
- Ensuring that each policy’s record maintained a comprehensive history across different stages, from initial submission to audit completion and billing, was a critical requirement. Managing this extensive data history without compromising system performance was complex.
- Integrating Gmail for policy extraction while ensuring strict security measures was challenging. Auditors sent emails with predefined subject lines, and it was crucial to securely filter, access, and process these emails without any security risks.
Solution By Kanhsoft
- We implemented Gmail API integration to automatically scan incoming emails and extract relevant attachments. We used custom parsing algorithms to detect and process policy details from PDF files, ensuring that all extracted data was accurately updated in the system. Additionally, we incorporated security measures to ensure that only authorized users could access and process these sensitive emails, addressing security concerns.
- We utilized Google Maps API to create a dynamic scheduling system that optimized routes based on auditor availability, and location preferences. The system allowed auditors to draw routes manually, offering a flexible tool to visualize and adjust their routes based on specific constraints. This feature ensured minimal travel time, lower costs, and adherence to both carrier operating hours and auditor preferences.
- We implemented a robust version control system within the platform to track all changes to each policy and ensure a complete, tamper-proof history. This system logs every update to the policy, including any status changes, audit results, and billing details, making it easy to trace back any alterations to the original data.
- We implemented Gmail API filters that specifically targeted emails with predefined subject lines, ensuring the system only processed legitimate audit emails. Additionally, we encrypted all email content using SSL encryption to protect sensitive data and implemented role-based access control (RBAC) to ensure only authorized users could access the data.
Key Features
- Automates the synchronization of policies from carriers using PDF and XML extraction, Gmail inbox integration, and SFTP server connectivity, ensuring seamless policy updates.
- Policies are auto-activated upon synchronization, with the ability to manually intervene before expiration, streamlining the workflow
- Leverage Google Maps and dynamic rules to schedule audits efficiently, minimizing travel time and costs while aligning with auditor preferences.
- Captures audit details during client visits, reduces paperwork, and seamlessly transfers them to billers for review and processing.
- Enable pencil-drawing tools in Google Maps for real-time route adjustments, finding audits en route, and streamlining travel logistics.
- Enables billers to verify audit details and generate invoices for carriers, with automated handling of inquiries and queries via SFTP.
- Seamlessly retrieve attachments and process policy updates from predefined email subjects while maintaining high-security standards.
- Automatically routes carrier queries back to schedulers, ensuring quick and accurate resolutions to maintain workflow continuity.
- Synchronizes schedules with Google Calendar and integrates with Gmail for task notifications and policy-related email processing.
- Supports multiple user roles like super admin, admin, auditor, biller, and carrier, each with tailored access to the system’s functionalities.
- Maintains a comprehensive history for all policy records and provides robust reporting features for better workflow insights.
- Enable detailed logging of audit activities, ensuring accurate time tracking and facilitating compliance audits.