Tracking efficiency, accuracy, and employee satisfaction in claims management
| Key Metrics | Current | Target | Status | Trend |
|---|---|---|---|---|
|
Avg. Claim Processing Time
From submission to resolution
|
3.2
days
|
≤ 3.0 days
|
Attention |
+0.4
|
|
Claim Approval Rate
% of claims approved
|
94.8%
|
≥ 95%
|
Attention |
+1.1%
|
|
Claim Rejection Rate
% of claims rejected
|
5.2%
|
≤ 5%
|
Attention |
-0.8%
|
|
Employee Satisfaction
Avg. satisfaction score (1-5)
|
4.2
/5.0
|
≥ 4.3
|
Attention |
0.0
|
|
Claim Re-submission Rate
% of claims requiring re-submission
|
8.4%
|
≤ 7%
|
Off Track |
+1.2%
|
|
Document Accuracy
% of claims with accurate documentation
|
92.7%
|
≥ 93%
|
Attention |
+0.9%
|
|
Claims per Processor
Weekly claims processed per staff
|
128
|
≥ 120
|
On Target |
+8
|
Claims per processor increased to 128/week
New workflow system improved efficiency by 18%
Approval rate improved by 1.1% this month
Enhanced validation checks reduced errors
AI-Powered Claim Validation
Pilot program launching next quarter
Mobile Claim Submission
App development in progress for Q1 2024
Re-submission rate increased to 8.4%
Medical claims have highest re-submission rate at 12.3%
Processing time exceeds target
Complex claims taking 5.7 days on average