A leading health insurance provider was struggling with manual, repetitive processes in policy administration and claims processing. These operations involved large volumes of data entry, verification, and reporting across multiple legacy systems, leading to high operational costs, error rates, and slow turnaround times.
To improve operational efficiency and accuracy, the client partnered with us to implement Robotic Process Automation (RPA) solutions.
Discovery Phase
During the discovery phase, we collaborated with key stakeholders to assess and prioritize automation opportunities across various departments:
Conducted process workshops and interviews with business teams.
Mapped current-state processes, highlighting bottlenecks and inefficiencies.
Performed automation feasibility assessments based on process complexity, rule-based operations, and system dependencies.
Key Processes Identified for Automation:
Claims validation and entry
Policy data migration
Premium reconciliation
Customer onboarding
Report generation and email notifications
Qeagle's Solution Approach
| Capability | Description |
|---|---|
| Intelligent Data Capture | Automated extraction from PDFs, emails, and portals |
| Rule-Based Decision Making | Automated validation against business rules |
| Workflow Orchestration | End-to-end process automation across systems |
| Exception Handling | Alerts & manual intervention for exceptions |
| Integration with Legacy Systems | Automated interactions with mainframe & ERP |
| Scheduled & Trigger-Based Execution | Unattended bots running 24/7 or on-demand |
Process Automation Approach
1. Process Assessment & Prioritization
- Identified high-ROI, repetitive, rule-based processes.
- Ranked processes using an Automation Opportunity Matrix.
2. Agile RPA Development
- Built bots using UiPath in iterative sprints.
- Reused existing libraries and components to accelerate delivery.
3. Secure Deployment & Governance
- Deployed bots on a secured infrastructure with role-based access.
- Established bot monitoring and governance through UiPath Orchestrator.
4. Hypercare Support
- Provided hypercare during the initial run period.
- Set up continuous monitoring and bot performance tracking.
RPA Footprints Across the Organization
| Business Function | Processes Automated | Impact |
|---|---|---|
| Claims Processing | Claims validation & entry | Reduced TAT by 70% |
| Finance & Accounting | Premium reconciliation, invoicing | 99% accuracy in financial reconciliations |
| Operations | Policy data migration | Enabled zero-error data transfer across systems |
| Customer Service | Onboarding workflows | Improved customer response time by 60% |
| Compliance & Reporting | Regulatory report generation | Automated daily and monthly reports |
Results Achieved
- 70% Reduction in manual effort.
- 99% Accuracy in automated transactions.
- Faster Turnaround: Claim processing time reduced from 3 days to 6 hours.
- Improved Compliance: Automated audit trails and exception logs.
- Scalability: Foundation set for expanding RPA across more business units
