Case Studies
AI to increase speed & accuracy
Executive Summary:
For the Claims Operations Management team became fundamental to measure and track performance of their workflow as the number of incoming claims increased.
Having access to clear and clean MI dashboard represented a challenge as to accurately monitor any diversion to the optimal trend of processing.
It was then the project’s success factor to enable a comprehensive yet simple dashboard where all relevant and important information would be captured to support quick decisions to be made.
Problem Statement:
With the increase of international exposure and the growth of the written policies, an expected growth in claims is understandable. The management team was challenged to monitor the income of several streams of claims via different mail inboxes, and the operational team’s capacity to process and turn around those claims in the agreed service level.
There were several metrics that were of the most importance to the management team to track the capacity and capability of the team that would have to be extrapolated via laborious spreadsheets which required a great level of data manipulation to understand if a claim was dealt with on time (meeting SLA) and how efficient was the overall flow of information upon requesting missing information.
Objectives:
To implement a MI Dashboard for the Management Team to use at any time to monitor the performance of the team and to report internally and externally key performance indicators such as: time from reception until acknowledgment; time waiting on missing information; hand overs between teams; reoccurrence of insufficient data provided originally; mistakes made whilst processing claims; predictability of influx of claims and resource allocation to monitor and process claims.
Project Description :
Throughout the entirety of this project an initial assessment of the relevant steps in the process flow have been identified, agreements and regulatory demands capture and all data points collected throughout the workflow. Through workshops, the Management Team surfaced the vital KPIs that would enable quick decision making concerning performance issues within the team, provide more training, identify bottle necks in the workflow to be streamlined, forecast of influx of claims vs team capacity to turn around the claims processing within target timelines.
Then with the use of mock ups of data captured through the processing application, it was possible to determine and showcase the real use and advantage of these dashboard for the Management Team to validate the assumptions mapped throughout the initial discovery.
Once implemented, the Management Team had a significant improvement on their own ability to quickly check, verify and deep dive into their team’s performance and the team’s ability to meet their time requirements and accuracy expectations.
Benefits:
1. Time saved downloading, manipulating and concatenating several spreadsheets to measure KPI metrics;
2. Simple and easy display for reporting internally and externally.
Conclusion and Recommendations:
There’s a wealth of information collected via different data points that if utilised properly can unveil a multitude of issues or opportunities for improvement of any team.
The use of tailored and bespoke dashboards for the needs of each individual team or department can provide vital information on how to manage more effectively workflows.
In this specific case it enabled an easy understanding which team members where more efficient, which needed more training, which days of the week/month there was to be expected a spike in claims arriving into the workflow and therefore adapting the resource allocation to deal with those spikes, preventing creating a backlog and missing deadlines.
We recommended as a first stage a complete and full analysis of what data was important, what data was captured and how to display that information in an easy and simple way.
