Analytics for Insurance Conference – Canada

OpenConnect’s Michael Cupps to Discuss the Future of Technology and Data Capture at the Analytics for Insurance Conference

Mr. Cupps will be a featured speaker at the Analytics for Insurance Conference session titled “Improve claims processing by identifying & understanding ‘dark events’”

Dallas, TX, May 4, 2015 – OC WorkiQ, a leader in workforce intelligence and business process analytics software and services, today announced that Senior Vice President Michael Cupps will be a featured speaker and panelist at the Analytics for Insurance Conference, May 11 – 12 in Toronto, Canada. Mr. Cupps will focus on how analytics can make the claims process more efficient and transparent.

The claims handling process involves large amounts of data, but unfortunately much of this data has historically not been tracked and measured in a meaningful way. Emerging technologies and the use of analytics that are capable of tracking this data are crucial to the future of the claims handling process.

Prior to the panel discussion, Mr. Cupps will deliver a presentation on understanding Dark Events, which are discrete actions that occur in the processing of a claim. The panel discussion will cover a number of key areas related to the role of analytics in the claims process. The additional capabilities that analytics enables – from developing new predictive models, to providing more insight into previously opaque aspects of the claims process – will be crucial to the evolution of the industry. Mr. Cupps will focus specifically on how to track and utilize previously unusable data in ways the industry has not seen before.

“As with any production process, the efficiency of the claims process solely depends on the knowledge of the best path to completion. In reality, that knowledge or visibility is not always clear,” said Michael Cupps, Senior Vice President, OC WorkiQ. “The only way to improve that process is to remove ‘Dark Events’. These are discrete actions that affect the state of claims, and normally go unrecorded by most claims processing and analysis systems.  Being armed with the ability to capture this data creates valuable and actionable analysis that can lead to greater efficiencies.”

The Analytics for Insurance Conference takes place May 11 – 12 at the Westin Prince Toronto. Mr. Cupps will give his presentation on May 11 from 2:50 p.m. – 3:10 p.m., and the subsequent panel discussion will take place from 3:30 p.m. – 4:00 p.m.

Don’t Apply Front-office Solutions to Back-office Problems

The Rail Yard and The Airport

The overall structure of work between the front-office and back-office is different.

While this is an oversimplification, call-centers operate much like a train. Call center managers build scripts and lay the track for their operators to move along, and operators are focused on direct interaction with the customer. Typically, tasks within the call center are short, transactional, and repeatable widgets of work. In the back-office, where human interaction is less important, these types of activities should be automated.

Back-office departments such as IT, account administration, accounting, and HR operate in nearly perfect contrast to the call center.

Back-office operations, such as insurance claims departments, function far more like a cargo airline pilot in the remote country. At the start of every day, each pilot receives several packages to deliver by the end of the week. The pilot knows the destination of each package or claim, but based on weather conditions, workload and/or environmental issues the path may vary. Two claims workers making the same run may chart a slightly different course, rely on different instruments, make adjustment based on obstacles, move at different speeds, and require the help of a co-pilot. Typically, tasks within the claims department are long, operational, and specialized widgets of work.

The Workflow

In the contact center, most associates with a similar functional focus perform tasks in a comparable and scriptable sequence. Most processes and sub-processes can be clearly defined in a workflow that all agents within the same department follow. An example of a simple contact center workflow can be found below. In this process, milestones such as the start of a call, completed customer account update, and resolution can be measured.

Generic Call Center Workflow

In most back-office operations, the structure of each work-unit may include measureable macro-level milestones, but variables such as claim complexity, availability of required documentation, each associates experience, and personal preferences make back-office operations difficult to script. For example, all claims may begin when the agent begins editing and end when the claim is submitted for payment. Between the start and end of each full unit of work, or fully processed claim, agents may take a variety of paths as illustrated below. These tasks, or sub-processes to a claim, may centralize around the claims system, but likely require the use of imaging software, email, internal IM/collaboration programs, phone calls, various research websites, and even social media.

Generic Claims Workflow

Use the Right Tool for the Job

While goals such as increasing productivity, finding hidden capacity, cutting costs, improving efficiency, and simplifying processes are shared between the front-and back-office, the methods for collecting meaningful performance data need to vary.

The focus for front-office measurement should be customer engagement, the customer’s perception of service quality, risk reduction, the frequency of call paths, time spent on each call, and the outcome of each call.  Depending on the nature of the contact center, factors such as call rate and upsell statistics may also come into play. This information can help a company identify market trends, test brand messaging, and collect feedback for product development. Data points can be used to identify contact center associates with the highest frequency of positive dispute resolution, or those that nurture the highest degree of customer satisfaction.

Back-office measurement should be improved cycle time, increased employee utilization, and decreased error rates. Desktop analytics and process analytics should measure hours spent on various types of work activities, completed sub-units of work, and process that each worker performs.

Desktop analytics built for the back-office are designed to measure all activity on the desktop, not just activity within the core system (e.g. claims system), and then identify patterns or relationships between applications and processes. Short, repetitive, and transactional processes uncovered through these tools should be automated, and additional gains should be accomplished through training associates to model top performers, increasing engagement through gamification, and reducing the complexity of unnecessarily time-consuming tasks with automatic data propagation or BPI.

To learn more about how your company can improve back-office measurement, please visit

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Recorded Webinar — Improve Claims Processing Through Workforce Analytics

Webinar hosted by AHIP and WorkiQ recorded on December 9, 2014, featuring Molina Healthcare

Using technology to empower efficient claims processing

WorkiQ measures the activities of your back office team in real-time. With this data you can be proactive in re-capturing non-productive time and increase productivity in the process.

Molina Healthcare will discuss their experience using technology to support and improve claims operations. Areas such as process improvement, employee performance score carding and employee efficiency can all be directly impacted if the right technology is implemented.

Discussion topics include:

  • Electronic time motion study
  • Measuring claims examiners based on standards
  • Comparing claims examiners to their peers
  • Comparing time spent in productive activities that drive engagement

This webinar will explore emerging best practices using big data in capturing and measuring back office productivity. Armed with accurate and real time data, this webinar will also discuss a best practices approach to systematically improve back office operations through coaching, employee engagement strategies, and improving overall team productivity to breakthrough levels.

What you will learn by attending:

  • How providing visibility through real time collection, measurement and on-going monitoring can impact productivity in claims operations
  • Reporting and dashboard strategies to effectively improve employee engagement
  • The power of an engaged workforce with an active voice in the productivity measurement approach and interpretation

Click here to see the recorded webinar.