Protective Online Claim Management System (OCMS)
Project Overview
OCMS (Online Claim Management System) is an enterprise internal claims processing suite designed to coordinate branch claim filings, medical document review, and multi-tier executive approval routing.
Architecture & Role: Lead Backend Developer designing relational database schemas, state transition workflows, role-based access control (RBAC), and automated financial audit logs.
Key Accomplishments & Architecture Highlights
- Business Problem: Replaced paper-based claim handoffs across regional branches with an end-to-end digitized, audited claims routing system.
- Multi-Tier Approval Routing: Structured approval workflows passing from branch claim intake to central medical scrutiny, actuarial verification, and executive signoff.
- Audit Logging & Fraud Mitigation: Immutable timestamped activity logs tracking every stage of document evaluation and claim disbursement decisions.
- Branch Productivity & TAT Metrics: Operational reporting monitoring average claim settlement turnaround time (TAT) across regional branch networks.
- Business Impact: Reduced claim settlement processing cycles from weeks to days while creating a verifiable actuarial audit trail.
Tech Stack & Tools
Project Category
Backend • Full Stack • Web Dev
Project Type
Professional Enterprise Project
System Screens & Interface Showcase
Click on any screenshot to open the interactive fullscreen preview modal.
OCMS Central Command Dashboard
Executive panel displaying active operational claims, pending approvals, regional performance charts, and audit metrics.
Enterprise Single Sign-On & Authentication
Secure authorization screen featuring corporate domain login and session security protocols.
Operational Claims & Audit Reporting
Analytical reporting section for generating detailed claim processing metrics and financial disbursement breakdowns.
Role Management & Permission Matrix
Granular user administration panel for configuring role permissions, access scopes, and module visibility.
