Business Process Modeling for Claims and Policy Administration

Module 5: Analyzing process performance and pain points

• Reading process models to identify bottlenecks, rework loops, and unnecessary complexity
• Distinguishing value adding work from waiting, duplication, and avoidable manual effort
• Using process views to discuss turnaround times, service levels, and control effectiveness
• Prioritizing improvement areas based on business impact and implementation effort

Module 6: Designing improved future state processes

• Moving from current state maps to practical future state designs
• Simplifying flows while preserving control, traceability, and customer service quality
• Improving handoffs, ownership, and decision paths across teams
• Designing exceptions, escalations, and alternative paths in a manageable way

Module 7: Process governance and documentation practices

• Keeping process models aligned with procedures, controls, and operating realities
• Establishing naming standards, modeling conventions, and ownership for updates
• Connecting process models to transformation work, controls, and reporting structures
• Using process documentation to support onboarding, audit, and continuous improvement

Module 8: Using process models in transformation and communication

• Communicating process changes to operations, management, and support functions
• Using models to support digitalization, automation, and workflow redesign discussions
• Structuring review sessions around business outcomes, risks, and implementation readiness
• Building a practical checklist for future claims and policy administration process modeling