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Insurance QA Audit Solutions for Claims and Underwriting Reviews

Fully automate your QA process, from data integration and to file selection, to audits and development planning.

teamthink Expansion Modules

In addition to teamthink's substantial reviewing, reporting, and self-authoring capabilities, Athenium offers a comprehensive suite of optional Expansion Modules that extend teamthink's power across the entire quality assurance process.

Learn about these teamthink Expansion Modules:

File Selection and Assignment: Save time, eliminate manual processes, and meet your most complex QA audit criteria.
Question-Level Responsibility: Gain insight from detailed information about all who handle a file, account, or policy.
Development Planning: Conveniently and efficiently leverage teamthink QA data for your development planning activities.
Data Integration: Ensure that your data is complete and accurate, without the hassle.
. File Selection and Assignment (FSA):

The File Selection and Assignment Expansion Module automatically selects appropriate claims, accounts, or policies to audit and assigns them to reviewers based on even the most complex criteria. The result is significant time savings, so you can move your focus to other managerial tasks.

  • Efficiency
    • Files are selected automatically, eliminating a very manual and tedious process.
    • With automated file assignment, reviewers know their workload and can easily access their assigned files.
    • Any file data loaded into teamthink can be pre-populated into the questionnaire during review.
    • This Module creates files in the system based on the selection. Reviewers are added and files are assigned automatically.

  • Validity and Accuracy
    • The right files are assigned to the right reviewers, automatically.
    • FSA will pick files based on a set of configurable rules to select a statistically valid sample that fits your business.
    • Reviewers see the most up-to-date information for the files being reviewed.
    • Avoid unwanted reviews of uninteresting files or files already reviewed.

  • Flexibility
    • Selections can follow a variety of algorithms, including stratification, organizational relationships, etc.
    • Assigned files may be rejected with a reason specified for its disqualification. Rejected files can be replaced automatically by alternates.
    • Reviewers can find files that focus on areas of concern and require additional audit focus.

Question-Level Responsibility (QLR):

The QLR Expansion Module enables more accurate, rapid and efficient end-to-end life cycle reviews of a claim file or underwriting policy. When multiple people or departments are involved in the handling of a file, QLR allows a reviewer to capture the behavior of individuals, supervisors or group contributors to the file, not just the most recent file owner. Greater clarity, efficiency, and accuracy are also gained by measuring performance at the question level, when files may be transferred between departments or there are gaps in file handling.
  • Accuracy
    • With QLR, individuals or groups are reviewed on all the work they performed -- both the files they own, as well as those to which they contributed but didn't own. Likewise, the file owner isn't given responsibility for the performance of others.
    • Supervisors can provide more comprehensive, accurate feedback on an individual's or group's performance -- both on files they own and on contributions made to files owned by others.

  • Efficiency and Speed
    • Identify the party responsible for each question, process or phase, and enable the reviewer to do a single review of a file involving multiple parties.
    • Instead of ignoring a question because there were multiple contributors, the reviewer can do a complete file review that takes into account multiple contributors.
    • Review a file with multiple party involvement one time only, rather than multiple times for each party.

  • Insight
    • QLR provides greater insights into files that are handled by multiple parties, measuring the impact of each party that interacts with a file.
    • Understand the overall performance of the file as well as the performance of each party involved with the file during its life cycle.
    • Measure and assign multiple instances of the same process step to understand the specific behavior of each individual involved in a process.
    • QLR leads to greater understanding of supervisory and leadership performance by rolling up results to higher levels in the organization.
QLR Product Sheet

Development Planning (DP):

The Development Planning (DP) Expansion Module eliminates the inconvenience of juggling multiple systems to develop training plans, check activity status, and monitor employee progress. Using the streamlined DP dashboard, managers can concurrently work on any of these activities while also reviewing QA reportlets on quality, leakage, top issues, and other audit metrics. Leverage precise QA data as a foundation for effective development planning - all on a single easy-to-use platform. With teamthink technology and a structured approach to development planning, this Expansion Module delivers a clear path to improving staff performance in Claims and Underwriting.

  • Convenience
    • Easily access a single system that combines audit data with development planning information.
    • Incorporate audit metrics directly into individual and team development activities.
    • Streamline supervisory approvals by viewing audit information together with development plans.
    • Plan employee participation in training activities to strengthen skills.

  • Effectiveness
    • Thoroughly track progress, recording when items were completed, how long it took, reasons for non-performance, and other monitoring functions.
    • Provide specific feedback sessions by referring to QA results during employee reviews.
    • Create plans for teams, offices, and lines of business based on detailed, aggregated QA data.
    • Assign and track action items for underwriting issues that need to be resolved prior to account renewal.
    • Refine best practices and provide a solid structure for the entire development planning process.

  • Employee Participation
    • Provide employees with appropriate access to relevant performance and review history.
    • Enable employees to making comments and agreeing or disagreeing with manager feedback.
    • Promote manager involvement in staff development by assigning them specific tasks.

Data Integration (DI):

When it's audit time, it's all about getting your review data in order. In addition to the difficulty of even collecting so much information, data in each spreadsheet and database is in a different format -- unfortunately, not the one needed for the audit system. If correctly preparing your data is tedious, manually intensive, and time-consuming, the teamthink Data Integration (DI) Expansion Module is your solution. By automatically gathering, updating, and transforming all the right data into the right format, your audit data is complete, consistent, and up-to-date -- and your staff is available for other important projects.
  • Efficiency and Convenience
    • Maintain your current data format, allowing teamthink to transform it for the QA system.
    • Ensure that new items, such as new offices or employees, are added to your system.
    • Register new users found in the data, and provide them with proper access to the system.
    • Incorporate data such as organizational hierarchy to determine access to reviews, or currency conversation rates for clear leakage reports.
    • Tie multiple underwriting policy records to a single account, or split an account into its component policies.
    • Accommodate multiple claims policy components, such as an accident affecting both home and auto.

  • Complete, Accurate Data
    • Concurrently upload the complete set of current, relevant data when an audit is started.
    • Import data from various organizational silos into teamthink.
    • Combine and reformat data from duplicate systems, such as separate claims or policy databases resulting from an acquisition.

  • Data Integrity and Security
    • Trust that claims numbers, office codes, and other data are consistent and conform to all constraints and rules.
    • Be notified when teamthink detects a data issue, such as a missing office.
    • Optionally schedule automatic data feeds to teamthink using industry-standard security methods, such as Secure File Transfer Protocol (SFTP).

  • Other Features
    • "Single Sign-On" functionality eliminates entering separate teamthink login credentials if you are already logged into the company's internal systems.
    • Securely send reports via email with automatic encryption using a secure email protocol.