使用六西格玛方法改进保险索赔处理流程

Q3 Engineering

International Journal of Six Sigma and Competitive Advantage Pub Date : 2020-12-29 DOI:10.1504/ijssca.2020.10034104

Boby John, P. Parikh

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引用次数: 0

摘要

这是一个关于减少外包保险索赔处理过程中意外和伤害索赔的每日积压百分比的案例研究。分析表明，索赔数量的波动以及行政人员和处理时间的无效利用是大量积压的主要原因。开发的解决方案是使用动态回归预测每日索赔量，并使用整数规划优化管理人员处理时间的利用率。该方案的实施将事故索赔处理的Cpk从0.21提高到1.18，将伤害索赔处理的Cpk从0.322提高到1.44。该解决方案还允许在周四和周五将一些高技能的管理人员重新部署到其他任务中。该方法可用于由不同技能水平的管理人员优化任何多任务处理过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Improving the insurance claim processing process using Six Sigma methodology

This is a case study on reducing the daily backlog % of accident and injury claims of an outsourced insurance claim processing process. The analysis showed that the fluctuations in claim volumes and ineffective utilisation of executives and processing time are the major causes of the high backlog. The solution developed is to forecast the daily claim volumes using dynamic regression and optimise the utilisation of processing time of executives using integer programming. The implementation of the solution improved the Cpk of accident claim processing from 0.21 to 1.18 and that of injury claims from 0.322 to 1.44. The solution also enabled in redeploying some of the highly skilled executives to other assignments during Thursdays and Fridays of the week. The methodology can be used for optimising any multiple task processing process by executives of varying skill levels.

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来源期刊

International Journal of Six Sigma and Competitive Advantage Engineering-Industrial and Manufacturing Engineering

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： Today, Six Sigma is recognised in many world class organisations as an effective means of achieving and maintaining operational excellence and competitive advantage. Six Sigma has proved to be successful in many manufacturing and service organisations to drive out variability from processes, improve process effectiveness and product/service quality, reduce defect rate, enhance customer satisfaction, etc. IJSSCA publishes papers that address Six Sigma issues from the perspectives of customers, industrial engineers, business managers, management consultants, industrial statisticians and Six Sigma practitioners.