Computerized workflow systems in customer service: a study at a health insurance carrier

Abstract

In Brazil, health insurance carriers need to have efficient customer service channels. A workflow system can assist in managing service channels. Hence, there is a need to understand how the implementation of a workflow system helps improve the productivity and central quality of customer service of health insurance carriers. This study aims to describe the stages of implementation of a computerized system for workflow at a health insurance provider. The results showed that this system enabled the monitoring of real-time operations, the reduction of costs, a decrease in customer complaints, the definition of performance indicators, and the ease of generating reports and retrieving documents. The study contributed to broadening the understanding of the application of computerized workflow systems in the context of health insurance carriers and to demonstrate how this system helps to improve productivity and service quality in customer service.