FINEOS: Gateway to Faster, More Efficient Claims Processing

Michael Kelly, Founder & CEO, FINEOSMichael Kelly, Founder & CEO
The humanitarian vision of placing people at the center of the modern life insurance systems inspired FinTech specialist Michael Kelly to establish FINEOS over 20 years ago. Since its inception, the company has been helping life, accident, and health insurance carriers to upgrade and replace their core systems with person-oriented, configurable, and user-friendly technology for group and individual insurance on a single platform. “At FINEOS, we strive to create a world where protection from illness, injury and loss is accessible to everyone,” remarks Kelly, Founder and CEO at FINEOS.

FINEOS’s customer-focused core product suite, FINEOS AdminSuite, is an advanced solution that tightly integrates with the core systems environment of any life, accident or health insurance carrier. Built on the FINEOS Digital Platform, the suite incorporates best-of-breed components— FINEOS Billing, FINEOS Claims, FINEOS Absence and FINEOS Policy.

FINEOS Claims facilitates best practice assignment and execution of claims handling throughout the claims lifecycle—right from the time a claim is registered all the way through to administering care and payments until the person returns to work and health. FINEOS Claims is available in the cloud and all parties involved in the claims process have access to the information they need online in real time. Being hosted in HIPAA and ISO 27001 compliant data centers, the information is highly secure. With FINEOS Claims in place, carriers can automatically prioritize and assign claims according to the level of importance and the needs of the person who requires care.

Leveraged by over 50 insurance organizations across the globe, FINEOS Claims is designed to benefit carriers of all sizes, from small departmental teams to massive teams with thousands of users and millions of claims annually. And with FINEOS Claims FastTrack, an out-of-the-box, cloud-based service, carriers can be up and running on FINEOS Claims in as little as 60 days.

At FINEOS, we strive to create a world where protection from illness, injury and loss is accessible to everyone

FINEOS Claims FastTrack comes with standard integrations and APIs, allowing carriers to easily connect to other third party software products and in-house systems. Over recent years, FINEOS has expanded beyond claims and has added a solution for total absence management called FINEOS Absence. This solution helps employee benefit carriers tackle the ever-evolving changes around absence management, including the complexities that legislation (i.e. FMLA, Paid Family Leave, ADA) brings to the table. The absence solution tightly integrates with FINEOS Claims and enforces compliance and uniformity, while also capturing the uniqueness and complexities of various leave plans, including occupational and non-occupational claims such as typical workers’ compensation and disability claims. Moreover, it provides a single book of record that is easy to access, view, and update by multiple users.

FINEOS’s multifaceted capabilities have come to the aid of many carriers. Kelly cites one such instance where a nimble carrier was facing difficulties in calculating payments correctly and gaining a full view of their claims data in their administrative system. FINEOS implemented FINEOS Claims tightly integrated to their legacy administrative system and helped the carrier discover that some of their claims payments were inconsistent and based on the wrong calculations. In another carrier, in just nine months of implementing FINEOS Claims, the carrier was able to understand and manage their claims exposure to the extent where they could confidently reduce their reserves, releasing millions of dollars into the business for other uses. This reduction of reserves gave the carrier a return on investment which effectively paid for the complete installation of the FINEOS system within the first 9 months of going live. The new claims system also enabled the carrier to implement digital self-service portals which resulted in a 25 percent decline in service requests from both their brokers and customers.

Presently, FINEOS is on a mission to continue extending its services to multinational clients by entering into the Asian insurance market. “We fully intend to help our customers navigate and complete their journeys of digital transformation,” Kelly signs off.