Tag Archive for: Process Documentation

Operational Excellence in Claims Management - Quality Business ServicesQuality Business Services

Operational Excellence in Claims Management: Scott’s COE Journey

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As an experienced manager of complex claims in the financial services sector, Scott was well aware of the unique challenges his team faced. Unlike typical operational teams, his group of experts dealt with high-value claims often involving litigation, each with its own complexities and nuances. Recognising the need for improvement, Scott turned to QBS’s Core Operational Excellence program, which provided him with the tools and strategies to achieve Operational Excellence in Claims Management. Through this program, he identified small, actionable changes that, when combined, delivered significant improvements to his team’s processes and outcomes.

THE ISSUES

Using a sharpened operational excellence perspective, Scott identified several key challenges that needed to be addressed:

  • Process documentation was rudimentary with limited standardisation
  • An over-reliance on individual expertise and judgement
  • A highly technical team – excellent depth but not breadth
  • Complex claims that were incorrectly sitting with normal claims teams 

ACTIONS TAKEN

Scott worked with his team on a number of targeted actions designed to address theses issues:

  • Developed guides and relevant job aides for complex claims
  • Standardised case management practices and increased use of templates, where applicable
  • Introduced fortnightly team knowledge sharing and lessons learned on large value claims using live case studies
  • Implemented a monthly learning calendar of relevant technical topics
  • Reinvigorated complex claims referral process
  • Allocated claim type based on team member skill
  • Engaged quantity surveyors and building consultants on large value claims
  • Introduced guides/checklists to identify recovery opportunities and ensure optimal case management

By standardising case management practices and implementing guides for complex claims, Scott demonstrated how Operational Excellence in Claims Management can address inefficiencies and deliver measurable improvements.

RESULTS

The results Scott achieved within six months are nothing short of amazing:

  • Productivity increased with the team servicing 15%-20% higher volume with same FTE
  • Complex claims referrals increased 50% resulting in savings of > $200k
  • Claim cycle time reduced from 250 days to 150 days 
  • Average claim cost reduced by 2% and increased claims with partial acceptance by 5%
  • Recovery rates from 3rd parties increased from 1-2% to 5-6%
  • Reduced claim cost on mid/large value claims by an average $10-15k per claim

The remarkable results achieved by Scott’s team showcase the true potential of Operational Excellence in claims management to optimise workflows, reduce costs, and enhance overall team performance.

If you would like your leaders to identify issues and quickly drive local operational improvement, click here to learn more about Core Operational Excellence and QBS’s other development programs.

Raising Business Maturity: Alex’s COE Journey - Quality Business ServicesQuality Business Services

Raising Business Maturity: Alex’s COE Journey

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Alex’s background is typical of many COE graduates as she had worked her way up from being ‘on the tools’. She had excellent instincts for operational excellence but lacked formal leadership training. Embarking on the Core Operational Excellence leadership development program taught Alex the science behind her instincts and the confidence to further develop with the 70/20/10 learning approach. When she was promoted into a large leadership role following an acquisition, she sensed many gaps in the two business areas that had come together. Over the following six months during her COE training, she progressively identified and addressed these gaps, raising business maturity and helping her team step up.

THE ISSUES

The many challenges Alex found were consistent with a low maturity business:

  • Misaligned teams 
  • Some operational processes had nil process documentation and key person risk
  • Several teams had limited or no process data
  • Limited engagement with stakeholders (siloed)
  • No business plan or monthly reviews
  • Perception of insufficient staff – in reality, too much time spent on waste activity
  • Few employees had active development plans and succession gaps existed 

ACTIONS TAKEN

This had to be a team effort so Alex engaged her leaders from the outset to gradually lift the business maturity with numerous actions:

  • Aligned roles, objectives and operating rhythms 
  • Developed a business plan with a monthly review mechanism
  • Team meetings run with agendas, minutes and follow-up actions
  • Closed gaps in process documentation
  • Implemented individual development plans to address key skill gaps and reduce succession gaps
  • Commenced manual data tracking on priority areas
  • Established regular stakeholder communications
  • Focused improvements on several inefficient processes

RESULTS

The results that Alex achieved within SIX MONTHS are incredible:

  • Cycle time on two core processes reduced 70%
  • Increased employee engagement
  • Continuous improvement driven by customer feedback and structured risk assessments
  • 100% succession coverage with no key person risks
  • Process improvements reduced waste equivalent to 1 FTE
  • Culture change with leaders working as a team, delivering on their plans
  • Interest reduction of $40k pa from reduced refund events 
  • Team are increasingly using data to separate fact from fiction

To this day, Alex still keeps her ½ day per week for working on the business – there is no going back!

RAISING BUSINESS MATURITY IN YOUR ORGANISATION

If you need your leaders to step up, raising business maturity and overall performance while reducing risks, click here to learn more about Core Operational Excellence and QBS’s other development programs.