Verint Performance Management - Insurance Claims

• The Problem:
  
  Implementation of the new claims processing system posed serious challenges. Parallel claims processing in the new and existing systems, new training requirements, and new service protocols stretched the organization’s resources. With two systems running simultaneously, inbound call volume, paper requests, electronic claim work pools, and non-call activities could not be managed effectively. Managers were asked to formulate complex staffing and training models with only a partial view of the business. Lack of data not only hampered future planning and forecasting, but led to short-term service deficiencies and escalating backlogs. Moreover,  planned efficiency gains from the claims processing system implementation were not being realized. The company’s management team realized that additional tools would be needed to maintain service level goals and manage performance in the new environment.
  
  
• Solution:
  

  Verint® helped the management team create and implement a totally new approach to address service
  performance goals. The planning process began with an extensive, observation-based review of front line processes. Existing processes across both claims systems were examined and re-engineered,  queue and work groups were realigned, and performance metrics were integrated across the board.  Next, the management team and Verint developed new work standards and, using Verint Performance Management software, created a set of new metrics presented to management in dashboards.
  
  Performance management dashboards aggregated all mission-critical data elements in one location. Offline work activities from multiple sources were integrated into a single workload indicator view, with work complexities and service contingencies assigned by function/area. All offline work activities were integrated with inbound call schedules to ensure optimal allocation of resources and consistent service delivery across all media, including telephone, fax, email and postal mail.
  

  
  
• Result:
  
  The new performance management approach and solution positioned this insurer to better leverage its claims processing engine, with swift and measurable results. Average speed of answer increased by 31-75%, depending on the specific queue. Overall service levels improved by 57%, and the cost per call declined by 40%. The insurer realized annual cost savings of $1.95 million and a 5.1:1 Return On Investment.