The Client is a national leader in the home warranty services industry and specializes in policy administration, underwriting and marketing. The organization had developed a best-in-class service system with capabilities in underwriting, private-label direct marketing, program administration, telecommunications, national service network management, and claims processing.
The main features of the application included claims management, authorizations, contract and warranty management, warranty enrollments and renewals, retention and other related functions in support of sales, marketing, purchasing, finance and accounting.
Some of the challenges facing the organization were that it needed:
- A system to support 24/7/365 service provided by over 500 associates
- To handle over three million calls per year (and growing)
- Training to deal with high turnover in the industry (40,000 hours of training per year)
- A process for replacing highly skilled claims analysts with a smart rules engine for claims authorization
- To automate the claims initiation process through an easy-to-use telephone or web system
- To provide self service to over 40,000 contractors and companies
- To be flexible enough to support over 900 marketing campaigns and combinations
- To provide integration with Oracle E-business ERP, CRM, BI, Imaging and other systems
The company was looking to implement the customized, high-efficiency solution and to integrate it in real-time with the new version of its ERP and CRM systems.
Auxis was engaged to design and develop a new enterprise system to manage the end-to-end process of claims and customer service, along with the rules engine, workflows and integration with other internal and external applications.
Business and technical requirements were evaluated to design a web-based solution capable of integrating with a variety of technologies and to scale to support the addition of more users and new functionality in the future.
- The web application features a service-oriented architecture (SOA) with a responsive and user-friendly web interface that requires minimal training for new users.
- The intuitive user interface guides the user through the flow and steps required to complete each transaction from new enrollments to claims processing and contract renewal.
- Telephony (CTI) and interactive voice response (IVR) capabilities were integrated with the new application to provide additional automation and to pre-populate screens with relevant information based on caller ID and customer responses to IVR system.
In addition, there were multiple vendors involved in the project, requiring creative and dynamic project management techniques to integrate the implementation teams and their respective methodologies. For example, packaged ERP applications followed a waterfall implementation approach while user-facing web applications would follow an Agile–SCRUM methodology. Dependencies were identified early on in the process and key integration points were prioritized and scheduled accordingly.
Auxis was also tasked with designing and developing a decision support rules engine to provide users with real-time analytics and to recommend the best course of action for every known scenario. Other scenarios would be recorded and incorporated into the algorithm for future events.
One of the goals of the project was to streamline processes and consolidate required information in a way that allowed the team to develop efficient user screens that will replace out-of-the-box screens of several backend applications such as Oracle ERP, CRM, Business Intelligence and other systems.
Main technologies utilized in building the solution include:
- Java as core development language
- ORACLE Database Technology
- ORACLE PL/SQL Database Programming Language
- Twitter Bootstrap for responsive UI and device portability
Auxis designed and implemented a service claim management and customer service web application and a decision support engine with the following benefits:
- The application enabled customers and service providers to obtain claim and account information on the web and via an automated voice recognition feature
- The process of dispatching the best-matched service provider based on multiple parameters was fully automated through the custom decision support engine.
- Service agents no longer need to manually decide which service provider best matches the service call scenario including location, availability and other criteria, and only authorized users are able to overwrite system assignments
- The new system reduced the time and resources required to train new employees
- A reduction in the number of calls needing to be handled by customer service
- The Service Oriented Architecture enabled external partners to integrate their systems with the new service claim management system via industry standard RESTful web services
- Service providers gained the ability to upload invoices and documents into the system, which reduced the work required by internal accounting personnel
- Three-way match of Invoice, PO and Service Claim was automated in the self-service section of the system, eliminating the need to manually review invoices for approved claims
- Reduced paper-handling and storage needs throughout the organization
- An electronic audit trail of activities is maintained in the system for customer service and research purposes