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Custom CRM Development for Health Insurance Agent Management

onix-systems.com

Insurance

Challenges with Existing CRM Solutions and Inefficient Agent Workflows

The company struggled with existing off-the-shelf CRM solutions (like Salesforce) due to their bloated feature sets and high costs. Their current manual processes for lead and customer management were inefficient, hindering account managers and managers' ability to effectively serve customers and track interactions. There was a need to digitize these processes at a minimal cost.

About the Client

A medium-sized health insurance company based in California focused on providing health plans and managing customer relationships through a network of insurance agents.

Project Goals

Develop a custom CRM system to digitize insurance agent workflows.
Improve the efficiency of account management for leads, opportunities, and customers.
Enhance communication and task management between agents and customers.
Ensure compliance with HIPAA regulations for handling Protected Health Information (PHI).
Provide actionable insights through reporting and analytics.

Core CRM Functionality

Lead capture via online forms and manual entry.
Automated lead assignment to agents.
Communication tracking (phone, email) and task management.
Document sharing and storage.
System notifications for new accounts and tasks.
Lead status tracking (Lead, Opportunity, Contact, Lost).
Account management (Leads, Opportunities, Contacts) with search and filter capabilities.
Comprehensive account information overview (contact details, MBI, healthcare proxy, health plan, physician, pharmacy, notes, documents, tasks, interaction history).
Reporting on key metrics (AEP/OEP success, lead/opportunity conversion rates).

Technology Stack

Cake PHP

PostgreSQL

Angular

External System Integrations

Customer Support Module (to retrieve customer information during phone calls and record support actions)

Non-Functional Requirements

HIPAA Compliance
Data Security (consent, least privilege, password rotation, inactive user logout)
Usability (intuitive UX/UI)
Performance (responsive and efficient)
Scalability (to accommodate future growth)

Expected Business Impact

The custom CRM system is expected to significantly improve agent efficiency, reduce operational costs associated with managing customer relationships, enhance customer satisfaction through improved communication and service, and provide valuable data insights for business decision-making.