Step-by-step guide to creating automated claims workflows in Moxo

At a glance

Building a claims workflow in Moxo eliminates email silos, lost attachments, and manual approvals.

A secure, branded portal lets claimants submit forms, upload documents, and track progress in real time.

Automation accelerates cycle times by up to 60% while maintaining SOC 2 and GDPR-compliant audit trails.

Insurers gain a faster, more transparent, and ROI-driven claims process with ready-to-use templates and automation tools.

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Why traditional claims handling is broken

Claims today often move at the speed of email. Adjusters chase missing documents. Approvals sit in inboxes. Clients get frustrated with long wait times and lack of visibility.

According to McKinsey, insurance companies that digitize claims can cut costs by up to 30%. For those that don’t, the risks are clear: longer cycle times, compliance gaps, and reputational damage in a market where digital-first experiences are becoming the norm.

Insurers know this pain: delays, silos, and errors that multiply with every handoff. That’s why modernizing the claims experience isn’t optional anymore; it’s the next competitive frontier.

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Why now is the time to modernize

• Rising claim volumes mean existing processes are already stretched.
  
• Fraud risk is increasing, requiring better oversight and audit-ready logs.
  
• Client expectations are set by digital-first industries like banking and retail — customers now expect the same seamless experience in insurance.

Delaying modernization doesn’t just cost efficiency; it erodes client trust and makes you vulnerable to faster competitors.

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What to evaluate before automating claims workflows

Decision-makers should focus on platforms that don’t just digitize forms but truly orchestrate the end-to-end claims journey. The must-have criteria include:

Secure client-facing portals: Customers and partners should engage in a single encrypted workspace with role-based access and audit trails.

Workflow automation: Approvals, escalations, and reminders should happen automatically, ensuring claims move forward without manual follow-ups.

Flexible controls: Branching logic for claim types, thresholds for approvals, and milestones to measure SLA compliance.

Integrations: Connections with policy admin systems, DMS platforms, and payment providers for seamless data flow.

Transparent reporting: Dashboards that visualize cycle times, SLA compliance, and bottlenecks across adjusters and regions.

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How to build a claims workflow in Moxo

Below is a structured, step-by-step process to build a complete claims automation workflow using Moxo’s tools.

Step 1: Create a new flow using templates

In Moxo’s no-code workflow builder, insurers can import a claims workflow template that includes intake, document requests, and approval logic. Templates accelerate deployment and ensure every workflow follows best-practice logic for transparency and compliance.

Example: A mid-sized insurer deployed Moxo’s claims template in under four weeks and saw a 45% drop in client complaints related to claims delays.

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Step 2: Add actions that matter

Each stage of a claim can be captured as a workflow action:

Intake forms collect structured claim details.

File requests trigger automatically for receipts, photos, or medical reports.

Approvals route to reviewers with automated escalation logic.

eSignatures finalize settlements securely within the client portal.

Every action lives inside a branded, client-facing workspace — eliminating scattered email threads and ensuring all parties stay aligned.

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Step 3: Set up controls for compliance

Use branching and conditional logic to route claims by type or value.
For example:

• Auto claims may require fewer reviews, while high-value property claims trigger additional oversight.
  
• Milestones can track SLA deadlines across each stage to ensure accountability and audit readiness.

These controls maintain consistency, reduce human error, and ensure every workflow aligns with your compliance framework.

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Step 4: Enable automations and integrations

Automations help claims move smoothly without constant follow-ups. Common automations include:

• Reminders for missing information.
• Escalations when reviews are delayed.
• Fraud flagging when anomalies appear.
  

Moxo’s integrations connect workflows to policy admin systems, DMS platforms, and payment providers — so data and documents move automatically between systems.

Example: One TPA integrated payments into Moxo’s workflow and reduced manual settlement errors by 80%.

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Step 5: Add Magic Links and real-time notifications

Magic Links let clients securely access their claim portal without needing to remember logins.
Every time a claim progresses — from document submission to approval — real-time notifications alert the claimant and relevant teams.

As one G2 review noted:

“Our clients loved the portal. For the first time, they didn’t need to email us for updates — everything was transparent and real-time.”

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Step 6: Track KPIs and performance

Once your claims workflow is live, use Moxo’s reporting dashboards to monitor performance:

• Cycle times and SLA adherence.
  
• Claim volume by region, adjuster, or line of business.
  
• Bottleneck analysis for continuous improvement.
  

Example: A global insurer used Moxo’s performance dashboards to cut SLA breaches by 35% in one quarter, achieving measurable operational improvements.

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How Moxo helps

Moxo is more than a workflow builder. It’s a secure, branded, client-facing platform designed to orchestrate complex external processes like claims. Unlike internal project tools, Moxo brings clients, partners, and staff into one unified portal.

Would you invite a claimant into your project management tool? Probably not. But with Moxo, you can — because it’s built to be secure, mobile-first, and client-friendly.

• Security: SOC 2, SOC 3, GDPR, encryption, and audit trails.
  
• Automation: Approvals, escalations, reminders.
  
• Portals: White-labeled, mobile-first, and client-ready.
  
• ROI: 40–60% faster approvals, 75% more client capacity, 95% less email.

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Bringing it all together

A modern claims process isn’t just about efficiency — it’s about trust. With Moxo, insurers can deliver transparent, secure, and fast claims experiences without increasing overhead. From template-based deployment to automated approvals, Magic Links, and AI, Moxo helps you orchestrate every step of the claims journey.

Ready to modernize? Book a demo or request an ROI consultation to see how Moxo can transform your claims workflows.

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FAQs

How does Moxo pricing work for claims workflows?

Moxo offers flexible pricing per-seat and per-workspace, with enterprise options for high-volume insurers.

How fast can we implement a Moxo claims workflow?

Most organizations launch a branded claims process within 2–4 weeks using ready-to-use templates.

Is Moxo compliant with insurance regulations?

Yes. Moxo is fully SOC 2, SOC 3, GDPR, and ISO certified, with encryption and audit trails for regulator-ready oversight.

Can Moxo integrate with my existing claims or payment systems?

Yes. Moxo connects to core systems through integrations and APIs, enabling seamless claims management.

What ROI can insurers expect with Moxo?

On average, Moxo customers achieve 40–60% faster approvals, a 75% increase in claims capacity, and a 95% reduction in emails.

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