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Healthcare Adminstration

NEEDS-BASED RESULTS

 

Healthcare Adminstration

SITUATION

Healthcare Administration entity of a major corporation wanted to improve operational efficiencies, while maintaining and/or improving customer service levels.

DRIVER GOAL

  • Increase bottom line profits by $2.65 million by the end of the year.

RESULT

  • Added over $2.6 million in benefits through productivity improvements in Call Center, correspondence/ research and claims processing.
  • Decreased cost per minute by 18% and headcount by 14%.
case study image, CS-146 large

Case Study

Improve Profitability

Issue

A major corporation wanted to improve the operational efficiencies of one of its best operated and managed and most productive contracts, while maintaining and/or improving customer service levels within its Healthcare Administration, Claims Processing, Customer Support and Systems Support entity.

Highland Approach

The Highland Group conducted a Discovery and Design process that identified and detailed key issues, including opportunities to streamline processes, restructure and define roles and responsibilities, and improve training.

Actions Taken

  • Streamlined processes, enabling progression to a paperless environment.
  • Established targets for production and quality.
  • Implemented individual tracking of production to emphasize accountability and responsibility for results.
  • Delivered a revised organizational structure, including merging units, combined position descriptions and skills requirements to better balance resource loads and further reduce costs.
  • Reset suspense processing production standards and implemented an improved examiner training program.
  • Executed an outbound call campaign to top-tier providers.
  • Implemented new processes and tools to expedite, track and ensure providers who committed to convert to electronic processing actually did so.
  • Utilized regional representatives to follow up on campaign commitments via phone calls and site visits.
  • Increased claims processing productivity by 12.4% (from 127 to 143 claim lines per examiner per hour).
  • Increased utilization from 84% to 96%.
  • Achieved 105% of targeted benefit (an 18% improvement from the base).

Decreased cost per minute by

18%

while adding over $2.6m in benefits to the bottom line

Related Information

Client Partner

Financial Services, Marketing & Consumer Products

Petrina is a creative, hands-on executive with over 25 years of international business experience with a proven track record of working collaboratively across traditional boundaries and solving complex operational issues. She previously served at the senior executive level of one of North America’s leading financial institutions and several global consulting organizations. There, she led engagements serving industry-leading clients in United States, Canada, England, Germany, Austria, Switzerland, Norway and the Netherlands.

Project Leader

Financial Services

North America

Brandon is a senior project leader and consultant with more than 12 years of experience in helping financial services firms maximize revenue and control costs through continuous improvement. He specializes in implementing efficiency, service and quality process enhancements in Fortune 500 companies by utilizing Lean and Six Sigma principles.