Knowledge Rules’ vertical market expertise includes healthcare, insurance and financial services, including retail and wholesale banking, card services, capital markets, lending and back-office operations.
Knowledge Rules’ deep experience within each vertical industry, including services solutions that span call center, front-office or back-office support, and member or provider services, check, card, payments or other business areas, allows the Company to tailor service offerings to specific requirements and deliver demonstrable results that repay project costs many times over.
All Knowledge Rules projects receive the attention of senior staff with industry-relevant experience in your business. Typically, we work on-site at the beginning of the project and, as the project allows, we utilize remote and offshore resources to complete the project in the most efficient, timely and cost-effective manner.
Healthcare
Knowledge Rules staff has supported member and provider services projects at some of the largest healthcare insurance providers in the United States, helping to improve healthcare system interoperability. The Company has implemented projects in volume-intensive back-office operations to increase claims processing throughput, provide call center representatives with eligibility information, and integrate data from diverse backend systems.
The Knowledge Rules team has also helped customers deliver concierge healthcare service, while driving down operational costs and accelerating overall system return on investment. The Company has experience with HIPPA and other unique requirements for applications that deal with sensitive client information. In addition, Knowledge Rules team members have been contributors and speakers at National Blue Cross Blue Shield conferences on Call Center thought leadership.
Sample Healthcare Projects
• Project Management role at a major Blue Cross plan to facilitate a multi-step approach to back-end core claims system replacement while simultaneously implementing additional workflows and functionality to add new users. A critical goal involved ensuring interoperability with the existing Member and Provider Services front-end system in a manner that was transparent to end users, eliminating the need for training.
• Project Management, combined with Knowledge Rules’ technical and industry expertise, helped a major Blue Cross plan rapidly roll out new Member Services functionality. The project also leveraged key pieces of functionality in the Provider Services area for across-the-board service level gains.
• Upgraded and converted functionality to allow rollout of latest Windows operating system on all desktops.
Financial Services – Credit Card
The Knowledge Rules’ team has credit card experience in both the business and technology side of implementations. The Company has worked with the largest card processors and six of the top card issuers in Credit, Customer Service and Collections BPM applications. These projects increased productivity in a wide variety of ways including increased quick kill rates, automated credit approval and other processes, and automatic skills-based routing capabilities.
Sample Credit Card Projects
• Enhanced performance, enabled load balancing and improved system reliability for a major card call center BPM system.
• Upgraded GUI interface to provide a modern look and feel that streamlined workflows and simplified user training.
• Upgraded and added new workflows for an existing call center, enabling them to purchase new portfolios without major business disruption.
• Helped develop a dispute system for a major card company.
Check Processing
Knowledge Rules staff has driven projects that significantly increased productivity for customer service and exception handling in the check processing area. These projects implemented functionality to meet emerging requirements for initiatives such as check truncation and modern customer service interfaces while simultaneously encapsulating legacy systems so they can be modernized in the future. Knowledge Rules has detailed knowledge of the accounting, image and item management needs in today’s open system world.
Sample Check Processing Projects
• Converted a proprietary check database to Oracle to support and enable data access by more users.
Money Transfer & Payments
Knowledge Rules has implemented, upgraded and enhanced investigation and exception handling systems at the world’s largest financial institutions. Banks are constantly faced with the challenge of improving customer service while driving down operating costs. BPM implementations, such as those Knowledge Rules has performed, can effect this needed change by modernizing selected systems to better integrate with the bank’s long-term IT strategy while at the same time reducing the bank’s risk due to fraud and unauthorized transactions.
Sample Money Transfer & Payments Projects
• Modernized an existing NT-based PegaSYSTEM (Windows NT has been de-supported by Microsoft) to Sun Oracle and enabled a new set of data mining tools.
• Modernized and upgraded an existing money transfer application to enable the bank to resell its services to other banks.
