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Understanding How the New Workforce Is Adapting to Higher Caseloads with an Insurance Claims Administration System

Even though technology is quickly transforming the insurance sector, managing a shifting workforce is one of the main issues claim organizations have to deal with. This is partially because they’re constantly under pressure to increase profits and reduce costs. Consequently, many are looking for ways to save money by using less-experienced adjusters.

As a result of this trend, adjusters often have less experience using current tools, lack long-term commitment, and have limited industry knowledge. To address these challenges, companies must make sure new hires can manage claims with the least amount of interruption. And the stakes are high: Employee changes can significantly affect the effectiveness and caliber of a claims operation if they are not appropriately mitigated.

Therefore, claim companies have a lot on their plates: They must consider how to maximize efficiency, cut expenses, and boost productivity. Using technology to automate processes and workflows can increase productivity while also bridging the experience gap.

Benefits of Automated Claims Administration for Less-Experienced Adjusters

Less-experienced adjusters, despite being new to the industry, can be a powerful asset if you have the right claims administration system in place.

Less Time Invested in Acclimating to Procedures

Because your claims administration software can come with an intuitive, modern design, it’s easier for newer adjusters to get used to your system. With software, your systems are streamlined. You get consistent workflows, not only for adjusters, but across other departments as well. Also, because each adjuster uses the same, predictable steps for each case, they quickly get accustomed to what comes next and the steps they have to take.

More Consistency in Claims Practices

The claims process can have a lot of moving parts, and it can be easy for each individual to manage them differently. While freedom can be a good thing, without a unified system, you can end up with inconsistencies that negatively impact the process. But with claims management software, you can set up consistent practices that all adjusters have to conform to.

For newer adjusters, this is particularly helpful because the software gives them definitive steps, and they can structure their adjustment processes around these. This helps eliminate problematic hang-ups, regardless of whether they’re handling property claims, natural disaster claims, those related to cybercrime, or others.

For example, if an adjuster has to interview healthcare professionals, policemen, firemen, or others, you can use your insurance claims management system to dictate the number of interviews each adjuster needs to conduct, as well as which people to talk to. You can also use the system to require different interviews for each type of claim. This way, when the adjuster opens the software, they have a concrete roadmap to follow.

Easier Compliance Alignment

Compliance should be at the forefront of an adjuster’s mind, whether they work for a public entity or a private company, regardless of how new they are to the profession. But this can be a lot to handle, especially if they’re still acclimating to their complex roles. With an insurance claims management system, however, you can lift some of the burden off their shoulders by ensuring that steps needed to meet compliance requirements are interwoven into your system.

For example, in Manitoba, Canada, adjusters are required to make policyholders aware of deadlines “with respect to prescription periods under the terms of the policy and under the Insurance Act of Manitoba.” In other words, they need to be prompt about making sure policyholders get specific information at the right time.

With an insurance claims management system, you can ensure the software requests verification that adjusters have made policyholders aware of important information by a certain time. In this way, you eliminate the guesswork and provide a new adjuster with the kind of structure they need to do their jobs with confidence.

Smoother Transitions Between Claims Adjusters

Another benefit of an insurance claims management system is the way it can enable smoother, time-saving transitions as one claims adjuster hands a case to another. Whether you’re trying to balance out the workload or someone has gone on vacation, your software can make the process of figuring out what has to be done with the claim straightforward.

For instance, if there are a few more factors to take into consideration before finalizing the claims payment, the new adjuster can take a quick look at the platform and figure out which boxes still need to be checked off. The system guides them through the adjustment process, eliminating uncertainty as to what needs to happen next—even if they got the case just a few minutes prior.

How Claims Administration Software Benefits Experienced Adjusters

Even experienced adjusters have difficulties. An adjuster's usual workload not that long ago ranged from 65 to 80 open cases. But now, an adjuster's caseload typically ranges from 125 to 150 open claims today. Therefore, claim companies have to consider how to maximize efficiency, cut expenses, and boost productivity. Intelligent technology, such as robotic process automation (RPA), holds the key.

For more experienced adjusters, claims administration software makes several aspects of their day-to-day tasks more efficient. For example, workflows are smoother thanks to the automation of key documentation involved in the adjustment process. The result? Experienced adjusters can handle an increased caseload, simply because they can accomplish more with less effort.

With Ventiv’s Claims Administration Software, you get a comprehensive claims management system that makes it easy for both new and experienced adjusters to do their jobs. In this way, you can reap the benefits of a new workforce without sacrificing quality of service. To learn more, connect with Ventiv today.


Sep 20, 2023

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