8 MINUTE READ
As a claims operations manager, you’re constantly balancing multiple priorities: managing all incoming claims, monitoring team performance, ensuring compliance, and meeting leadership’s expectations for handling time and LAE, all while striving to provide exceptional customer service to policyholders. It’s a demanding role that calls for effective prioritization and strong leadership to achieve success.
The big question is: How can you work smarter and not harder, achieving more while doing less?
The answer lies in how you look at your data.
Claims data is a goldmine of insights. It holds the power to optimize your processes, improve decision-making, and streamline operations. But raw data alone is overwhelming. It is usually scattered across different files and documents. To truly benefit from it, you need the ability to turn this data into actionable insights. That’s where comprehensive dashboards come in. Dashboards consolidate your claims data into visual information in one central location, allowing you to understand your operations immediately and take actions to improve your claims handling and business KPIs.
To master your claims operations, you need a technologically advanced claims management system (CMS) that molds disparate pieces of information (such as adjuster notes, customer communications, claim timelines) into a cohesive whole, giving you a real-time, actionable view of your operations.
Five Sigma’s Management Dashboards: Proactive Claim Management Capabilities
Five Sigma is an innovative leader in the Insurtech landscape, committed to transforming the claims management process through cutting-edge technology.
Five Sigma’s claims management platform was born AI-native, engineered from day one to harness the full potential of artificial intelligence and automation. Five Sigma’s AI integration introduces new levels of efficiency, fundamentally transforming the way claims are managed. With a strong AI core, Five Sigma delivers advanced automation and actionable, data-driven insights that empower claims managers to make quicker, smarter decisions, enabling teams to operate at peak performance with precision and speed.
Five Sigma’s platform consolidates all existing claims data into clear, actionable reports and dashboards, providing managers with a real-time, comprehensive view that enhances decision-making and operational oversight.
Five Sigma management dashboards provide:
- Real-Time Data Access: Instantly view up-to-date claims metrics and operational data, enabling faster decision-making.
- Create Your Own Custom Dashboards: Design and configure multiple dashboards to fit your unique claims processes and metrics, ensuring you have the insights you need at your fingertips.
- Proactive Problem Identification: Enjoy a clear visibility of potential bottlenecks before they occur.
- Enhanced Team Oversight: Monitor adjuster performance and workloads in real time, enabling more effective team management and task distribution.
Five Sigma’s Supervisor’s Dashboard
Supervisor’s dashboards are essential tools for claims leaders, offering a real-time, data-rich overview of every aspect of the claims process. By centralizing key metrics such as open claims, exposures, communications, and workload distribution, supervisor dashboards enable managers to transform raw data into actionable insights and make informed decisions quickly.
1. Open Claims
Having a real-time view of all open claims enables managers to quickly assess the team’s workload and prioritize cases. This comprehensive claim allows efficient resource allocation, reduces bottlenecks, and shortens the claims cycle, ultimately enhancing both productivity and customer satisfaction.
2. Open and Inactive Exposures
Tracking open exposures and identifying those with no recent activity helps managers ensure that all risks and aspects of claims are actively managed, reducing the potential for claim leakage, and ensuring that exposures are addressed promptly.
3. Open and Pending MOIs
Monitoring open Methods of Inspection (MOIs) and flagging those pending ensures inspections remain on schedule. By staying on top of overdue MOIs, managers can expedite delayed assessments, reducing claim cycle times and keeping the process efficient and organized.
4. Unanswered Communications and Open Notifications
Highlighting unanswered communications and open notifications (general and also per adjuster) allows managers to quickly spot any pending responses needed for claimants, vendors, or other stakeholders. This metric ensures timely follow-ups and supports a high standard of customer service. It is also a powerful tool for recognizing an adjuster’s workload and providing the necessary support.
Five Sigma’s Operational Dashboards
An operational dashboard provides claims managers with a detailed view of the financial flow within each claim, enabling precise tracking and prioritization. This specific dashboard is exposure-focused, aiding in strategic financial planning by providing a concise picture of potential liabilities, helping set accurate reserves, and aligning financial strategies with real-time risks. It reduces claims leakage by flagging issues early and supports compliance with regulatory standards, ensuring claims are handled promptly and accurately to enhance customer satisfaction.
1. Improved Resource Allocation
By viewing exposures by category and status, managers can allocate resources more effectively. For example, exposures that are aging or high in volume can be flagged, ensuring that claims requiring immediate attention receive the necessary care.
2. Early Identification of Claim Leakage
The operational dashboard can help identify trends and inconsistencies, such as exposures that are frequently reopened or remain unresolved for long periods. These indicators often signal inefficiencies or errors in the claims process, commonly known as “claims leakage.” Early identification of such trends helps managers mitigate financial losses and improve operational efficiency.
3. Focused Performance Tracking
Tracking exposure closures, handling times, and activity rates allows managers to evaluate the effectiveness of claims handling at a detailed level. This granularity supports targeted improvements, such as reducing cycle times for specific types of exposures or identifying where additional training may be needed for adjusters handling complex claims.
4. Strategic Financial Planning and Compliance
Exposure-focused data provides a more accurate picture of potential liabilities, which is critical for financial planning and compliance. By closely monitoring exposure trends, insurers can set more accurate reserves, align their financial strategies with actual risk profiles, and ensure compliance with regulatory requirements regarding reserves and claim payouts.
Five Sigma’s Financial Trends Dashboard
The Financial Trends Dashboard offers a comprehensive overview of the financial performance and key cost metrics related to claims. By focusing on indemnity and expense reserves, paid amounts over time, expected recoveries, and other financial indicators, this dashboard enables claims managers and financial officers to track spending patterns, anticipate recoveries, and assess the efficiency of payment processes. It supports strategic decision-making by highlighting areas of financial risk and opportunities for cost optimization.
1. Indemnity Information (Reserves and Paid)
The dashboard provides current data on indemnity and expense reserves, along with the amount paid for both indemnity and expenses this month. This insight allows managers to monitor the adequacy of reserves and ensure that payments align with expected liabilities. Tracking these figures helps in budgeting and ensures compliance with reserve requirements, while highlighting areas where costs may need better control.
2. Paid Amount Over Time
The “Paid Amount Over Time” chart visualizes indemnity and expense payments over the past six months, revealing spending trends. By analyzing these patterns, managers can identify months with peak expenditures, assess budget impact, and make adjustments to avoid cost overruns. This trend analysis also assists in planning for future financial needs and understanding cost drivers within the claims process.
3. Expected and Received Recovery
This section tracks anticipated versus received recovery amounts, providing insights into the effectiveness of recovery efforts. By comparing expected recoveries with actual receipts, managers can evaluate the success of subrogation and recovery strategies, identify potential gaps, and improve recovery processes. This data is crucial for minimizing net loss and maximizing financial efficiency.
4. Average Exposure Cost
The dashboard shows the average cost per exposure, both by coverage type and over time. This metric highlights the financial impact of different types of exposures, enabling managers to focus on high-cost coverage areas. Monitoring average exposure costs helps in setting accurate reserves, optimizing claims handling for cost-intensive exposures, and prioritizing efforts to reduce the financial impact of specific claim types.
5. Average Time to First Payment
Tracking the average time to first payment by coverage type offers insights into the responsiveness and efficiency of the claims process. Shorter times to payment can enhance customer satisfaction, while longer times may indicate potential delays in processing. By identifying coverage types with longer payment timelines, managers can implement strategies to expedite the initial payment, improving both operational efficiency and policyholder experience.
Five Sigma’s Customizable, Self Service Dashboards
Five Sigma’s customizable dashboards provide claims managers with direct access to the exact metrics they need, enabling precise tracking of KPIs like financial reserves, recovery rates, exposure costs, and specific adjuster performance.
This tailored approach allows managers to configure dashboards on their own, to match their specific operational priorities, and choose their own filter options, ensuring that every data point displayed directly supports decision-making. With critical metrics consolidated in one view, managers can efficiently monitor claims, identify issues, and allocate resources where they’re needed most.
Five Sigma’s dashboard customization enhances visibility, enabling claims organizations to drive efficiency, reduce costs, and meet performance targets with a clear, data-backed strategy.
In Conclusion
Dashboards are an invaluable tool for claims managers, providing a centralized view of key metrics to simplify decision-making and optimize team performance. They are crucial for navigating the many-faceted roles of claims managers with efficiency and clarity. With Five Sigma’s advanced dashboards, managers gain real-time insights that boost efficiency, reduce costs, and enable a proactive, data-driven approach to exceptional claims management.
