Claims Done by Computer

A combination of IT knowledge and business acumen has made Lizanne Mailhot the perfect controller to implement new, automated systems for benefits provider Pacific Blue Cross

Lizanne Mailhot likes learning new things in her personal life just as much as she does in her professional life. She went parasailing for her 50th birthday, recently started playing soccer, enjoys white-water paddling, and even goes to boot camp. “People say, ‘Really? I never would have guessed,’” Mailhot says with a laugh.
Lizanne Mailhot likes learning new things in her personal life just as much as she does in her professional life. She went parasailing for her 50th birthday, recently started playing soccer, enjoys white-water paddling, and even goes to boot camp. “People say, ‘Really? I never would have guessed,’” Mailhot says with a laugh.

Moving a claims-administration process online requires a leader who possesses not only business acumen but also technical expertise. That’s exactly what benefits provider Pacific Blue Cross found in Lizanne Mailhot, who, for the past three years, has been serving as the company’s controller. Here’s a look at the numbers behind her expertise and behind the initiatives she has put in place to improve the efficiency of the nonprofit.

30 years

Early in Mailhot’s 30-year career, a supervisor gave her a significant piece of advice: if she didn’t know something, she had to admit it and then learn it, whether on her own through course work or through a mentor. She took that to heart and has since worked in a multitude of industries, including aerospace, government, forestry, shipping, and health benefits. “I like learning,” she says.

Another supervisor told Mailhot that if she wanted to be promotable, she had to make it easier for her manager to promote her, and that meant sharing her knowledge. “Otherwise, who will do your job when you leave?” she asks. “At the time, I hadn’t even thought about that. I thought, ‘I don’t want to do this piece of work for the rest of my life, so I’ll show someone else how to do it.’”

2010

Just prior to joining Pacific Blue Cross in 2010, Mailhot spent three years implementing the enterprise resource planning (ERP) system at Seaspan, which involved a systems upgrade and the documenting of related processes. “It was really a change-management role,” Mailhot says, “and when the project ended, my résumé had a mix of project management, process documentation, and finance, which is one reason Pacific Blue Cross wanted me. The organization was in the process of a large implementation of a new claims-administration system and needed someone on the finance team who could communicate with IT.” Mailhot signed on as controller and got to work.

18.5 million claims

As British Columbia’s leading provider of health and dental benefits, Pacific Blue Cross serves more than 1.5 million members through approximately 8,000 employee group plans and 39,000 individual plans for those who do not have employer coverage. All told, the nonprofit processes more than 18.5 million claims each year, resulting in billings close to $1.3 billion and a total revenue of $339 million. Up to now, it has processed claims using two main legacy systems: one for health claims and one for dental claims. In April 2014, though, the company will take its new claims-administration system online—one system that will pay for everything. That will allow the company’s 70-member call centre to handle both health and dental claims, which Mailhot says saves time and reduces errors. “One is just easier than two,” she says.

1 system

The new claims-administration system is just one project Mailhot has tackled during her tenure at Pacific Blue Cross. When she arrived, the organization had several legacy systems going in virtually every department. “Even in finance, we had two or three accounting systems, and different reports came from different systems, so we had to add them up to calculate things like revenue,” she says.

Her immediate goal was to reduce redundancy and, in the process, automate everything. An example of this effort is the new purchasing system: now, instead of a piece of paper going from request to approval to order placement to receipt, it is entered into a system, which sends it to an approver, then to the vendor, then back to billing.

40 employees

The new normal, Mailhot says, is that things change all the time, so she encourages her staff of 40 to be adaptable, both with regards to technology and new ideas. She is also committed to constant communication via an open-door policy. “I ask people, ‘What do you want to do when you grow up?’” Mailhot says. “If you’re happy doing what you’re doing, that’s great, but if you’re aspiring to grow your career, let’s try to do things, even in your current role, that will help with that. And if I don’t know about it, I can’t do anything about it.”

Mailhot believes in challenging employees while also patting them on the back for a job well done. “A lot of people only hear the bad stuff,” she says, “and I think they should hear the good as well.”
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THE BOTTOM LINE

Title
Controller

Industry
Insurance

Years in the business
33

Where did you start your career?
Winnipeg, as a cost accountant for an aerospace company.

Describe yourself in three words 
Fair, honest, caring.

Advice to those just starting in finance
If you have an area you like or are passionate about, see if you can find a role in that area. Don’t be afraid to find temporary work to build your experience and determine what you would like to do in your career.