Healthcare Claim Processing

A diversified health care company that provides managed care services targeted to government-sponsored healthcare programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., the company offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. The company serves approximately 4 million members nationwide as of 2014.
Key Drivers for implementing the Big Data solution:
The company wanted to improve the efficiency and accuracy of claims processing and improve the overall patient experience. Current practice of processing claims, based on daily and monthly batch jobs, was inefficient. Organizations primary concern was to increase patient experience by achieving federal five-star rating. Enable rapid growth of the underlying IT infrastructure as and how the company grows with new acquisitions and product launches. Generate raw data reports for Data Scientist and efficient finance models for future product launches.