Validating Claims with Advanced Analytics John Standish Chief - - PowerPoint PPT Presentation

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Apr 07, 2024 47 likes •239 views

Validating Claims with Advanced Analytics John Standish Chief Marketing Officer Are Your Team Members Synchronized? Business Process U/W Compliance Claims Risk Investigate Medical SIU Business Validate FWA Next Pay Steps

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Validating Claims with Advanced Analytics

John Standish Chief Marketing Officer

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Are Your Team Members Synchronized?

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Business

Claims U/W Risk

Compliance

Investigate

SIU

Validate

Pay FWA Next Steps Medical

Business Process

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Rule of 3:

1. State the problem.
2. Discover the possibilities.
3. Execute.

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Google Servers, Douglas County, GA

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447,000 +

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Insurance and Risk

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How do you validate a claim? Indicators? Risk? Pattern recognition

machine learning!

Cognitive computing.

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Advanced Analytics in an Insurance Claim Context

Data Management Federated Searches Business Intelligence Predictive Modeling Social and Network Analysis Machine Learning Social Media Analysis Text Analysis NLP

Reactive Proactive

Analytics

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“Modus Operandi “- a particular way or method

f doing something, especially one that is

characteristic or well-established Claim

MOA

MOP

Analysis

Invest.

Pay/Decline

100

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What is your data revealing?

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Where are you going? How will you get there?

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Thank you

jstandish@infinilytics.com (760) 809-3553 http://www.linkedin.com/pub/john-standish/9/548/a1b/ @JohnStandish136