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

Apr 07, 2024 •47 likes •237 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

  1. Validating Claims with Advanced Analytics John Standish � Chief Marketing Officer �

  3. Are Your Team Members Synchronized?

  4. Business Process U/W Compliance Claims Risk Investigate Medical SIU • Business Validate FWA Next Pay Steps

  5. Rule of 3: 1. State the problem. 2. Discover the possibilities. 3. Execute.

  7. Google Servers, � Douglas County, GA

  9. 447,000 +

  11. Insurance and Risk

  12. How do you validate a claim? Indicators? Risk? Pattern recognition -machine learning! Cognitive computing.

  14. Advanced Analytics in an Insurance Claim Context Business � Data � Federated � Intelligence Management Searches Reactive Proactive Social and � Social Media � Text Analysis � Network � Analysis NLP Analysis Machine � Predictive � Analytics Learning Modeling

  15. “ Modus Operandi “- a particular way or method Claim of doing something, especially one that is characteristic or well-established 100 MOA MOP Analysis Invest. Pay/Decline

  16. What is your data revealing?

  18. W here are you going? How will you get there?

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

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