Empowering Claims Processing with Intelligent Automation

Empowering Claims Processing with Intelligent Automation

Industry
Healthcare

A prominent organization in the workers' compensation insurance sector was burdened by outdated, manual claims review processes. Their teams spent countless hours on the lengthy manual review and data entry of claims from large, bundled PDF files, leading to frequent errors, slow system updates, and low productivity. This inefficient workflow created a significant bottleneck from document ingestion to final record creation.

Caelius Consulting engineered a modern, automated solution by creating an intelligent data pipeline. The system uses Intelligent Document Processing (IDP) to automatically split multi-page claim files and extract crucial data. MuleSoft securely transforms this data and integrates it into Salesforce, which serves as the central system of record. For quality assurance, a "human-in-the-loop" workflow flags low-confidence data for manual review via a custom, user-friendly interface.

This transformation delivered a faster, more accurate, and scalable case management system. The key impacts include:

  • An 80% increase in efficiency for record creation and claims review.
  • A significant reduction in manual effort and data entry errors.
  • An improved UI that increased user satisfaction and simplified manual review tasks.
  • Faster task completion and smoother day-to-day operations.

Download the full case study to learn how Caelius's dual expertise in Salesforce and MuleSoft can transform your document-driven processes.

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