For a policyholder, filing a claim is the moment of truth. Their entire experience hinges on how your team handles their case with clarity, empathy, and efficiency. Every internal process, from first contact to final resolution, directly impacts their perception of your company. That’s why measuring your team's success can't just be about internal targets; it must be tied to the customer journey. By focusing on the right key metrics for claims handler performance, you can gain deep insight into how your operations affect the people you serve. This data helps you identify friction points and streamline workflows to ensure a consistently positive and supportive customer experience.
When you're managing a claims team, you know that performance is about more than just speed. It’s a delicate balance between efficiency, accuracy, and providing a positive customer experience during what is often a stressful time for them. Tracking the right metrics gives you a clear picture of where your team excels and where they need support. It helps you move from guessing what’s wrong to knowing what to fix.
Focusing on a handful of key performance indicators (KPIs) allows you to pinpoint specific behaviors and process gaps. Are claims taking too long to close? Are customers frustrated with the process? Are simple mistakes leading to rework? The answers are in your data. By monitoring these essential metrics, you can build a more consistent, effective, and empathetic claims handling operation. Let's look at the seven metrics that matter most for evaluating and improving your claims handlers' performance.
The claims closure rate measures the percentage of claims your team successfully resolves within a specific period. Think of it as a primary indicator of your team's overall efficiency. A healthy closure rate suggests that your workflows are running smoothly and your handlers are effectively managing their caseloads. However, this metric doesn't tell the whole story on its own. While you want to see claims closing promptly, it’s crucial to ensure they are closed accurately. A high closure rate is great, but not if it leads to an increase in reopened claims or a drop in customer satisfaction.
Average handling time (AHT) tracks the average time it takes to settle a claim from the moment it’s opened to when it’s closed. This is a critical factor in the customer experience. When a claim drags on, customer frustration grows, and they may start looking for another insurer. Monitoring AHT helps you identify bottlenecks in your process. For example, if AHT is creeping up, it might signal a need for more training, better tools, or a review of your internal workflows. The goal isn't just to be fast, but to be thorough and efficient, resolving claims in a timeframe that feels reasonable to the customer.
Customer satisfaction scores tell you how customers feel about their experience with your claims process. After an interaction or the closure of a claim, a simple survey can capture valuable feedback. High CSAT scores are a strong sign that your handlers are not only processing claims correctly but are also communicating with empathy and clarity. This metric provides direct insight into the policyholder's perspective, helping you understand what your team is doing well and where the customer journey could be improved. It’s a direct line to understanding the human impact of your operations.
The claims reopen rate is the percentage of claims that have to be reopened after being marked as closed. This is a powerful indicator of quality and accuracy. If this rate is high, it often points to issues in the initial handling of the claim. Perhaps the handler rushed the process, missed key information, or didn't fully address the customer's issue. A low reopen rate, on the other hand, shows that your team is getting it right the first time. Tracking this metric helps you catch underlying problems that could be hurting both your efficiency and your reputation.
This metric calculates the average expense your organization incurs to process a single claim. It includes administrative expenses, investigation fees, and other operational overhead. Monitoring the expense per claim is essential for managing your department's financial health and operational efficiency. While the goal is always to manage these expenses effectively, it's important to do so without sacrificing the quality of the investigation or the customer experience. Streamlining workflows and equipping your team with the right tools can help reduce this figure while maintaining high standards of service.
First call resolution (FCR) measures the percentage of claims or inquiries that are fully resolved during the first contact with the customer. A high FCR rate is a win-win: customers are happy because their issue is handled quickly, and your team becomes more efficient by avoiding follow-up calls and emails. Achieving a high FCR often depends on empowering your handlers with the right information at the right time. A centralized and easy-to-use Knowledge Management system is fundamental to helping agents provide accurate answers and resolve issues on the spot.
Quality assurance scores are based on internal reviews of how claims are handled. These evaluations use a predefined set of criteria to check for accuracy, compliance with company policies, and adherence to regulatory standards. QA scores provide a structured way to ensure that speed never comes at the expense of quality. The insights from these scores are invaluable for providing targeted feedback and identifying specific training needs. A strong Connected Quality Assurance program is the foundation for consistent performance and continuous improvement across your team.
Tracking claims handler metrics is about more than just hitting targets. It’s about understanding the story your data is telling so you can make meaningful improvements to your operations. When you consistently measure performance, you gain the clarity needed to refine processes, support your team, and ultimately deliver better outcomes for customers. The right metrics act as a roadmap, guiding you toward a more efficient and effective claims processing system. By turning raw data into actionable insights, you can move from simply monitoring performance to actively shaping it. This proactive approach helps you build a resilient team that can handle challenges with confidence and consistency.
Performance data shines a light on how your team’s daily workflows are actually functioning. Metrics like Average Handling Time and First Call Resolution can quickly reveal where processes are running smoothly and where they’re getting stuck. As one industry expert notes, "improving claims handling isn’t just about technology or processes, it’s about people." When you see a metric dip, you can investigate the human element. Is a complex procedure causing confusion? Is the information needed to resolve a claim hard to find? These insights allow you to streamline steps, update your Knowledge Management system, or provide targeted training to make your team’s job easier.
Knowing your team’s strengths and weaknesses allows you to assign tasks much more strategically. Performance metrics help you identify which handlers excel at complex, high-stakes claims and who might be better suited for high-volume, straightforward ones. This data-driven approach ensures you can allocate resources effectively, putting the right people on the right tasks. It also highlights opportunities for growth. If a handler is struggling with a specific claim type, you can provide them with Dynamic Coaching and support to build their skills. This not only improves team efficiency but also invests in your employees' long-term development.
Metrics are your best tool for diagnosing hidden problems in the claims lifecycle. A sudden spike in the Claims Reopen Rate or a drop in CSAT scores for a particular team can signal an underlying issue that needs attention. By regularly reviewing performance data, you can pinpoint bottlenecks before they become major roadblocks. For instance, consistent errors on a certain form might indicate that the form itself is confusing. A quality assurance platform can help you spot these trends across interactions, allowing you to implement a targeted fix, like redesigning the form or creating a new job aid, to resolve the issue at its source.
Once you’ve decided which metrics to track, the next step is to build a system that makes the data meaningful. Simply collecting numbers isn’t enough; you need a thoughtful approach to turn those metrics into real performance improvements. The right practices ensure that your data is accurate, your feedback is fair, and your team is empowered to succeed. By focusing on consistency, visibility, and actionable insights, you can create a performance management process that supports your handlers and drives better outcomes for your customers. Here are four best practices to get you started.
One of the biggest challenges in performance tracking is subjectivity. If every team leader evaluates performance differently, your data becomes unreliable and your team may feel the process is unfair. Establishing clear, objective criteria is the first step to ensuring your assessments are fair and consistent. Create standardized scorecards for your Connected Quality Assurance program that define exactly what a successful interaction looks like. When everyone is working from the same playbook, you can trust your data and provide feedback that is both accurate and equitable. This consistency builds a strong foundation for every other performance improvement effort.
Annual or even quarterly reviews are too infrequent to drive meaningful change. To make a real impact, your team needs immediate visibility into their performance. Real-time dashboards allow claims handlers to monitor their performance metrics continuously, empowering them to make quick adjustments throughout the day instead of waiting for a formal review. For leaders, these dashboards provide a live view of team performance, making it easy to spot trends, identify challenges, and offer support when it’s needed most. This instant feedback loop helps handlers take ownership of their development and keeps everyone aligned on key objectives.
Data can be overwhelming if it isn’t presented clearly. The best reports don’t just show numbers; they tell a story and point toward a solution. Actionable reports should highlight key performance indicators and provide insights that lead to immediate improvements in claims handling. Instead of just showing a low CSAT score, a good report might connect it to specific interactions or knowledge gaps. This allows you to move directly from data to a solution, like targeted Dynamic Coaching or a refresher on a specific process. When your reports are designed to prompt action, they become a powerful tool for driving progress.
Metrics provide the "what," but a great review uncovers the "why." Improving claims handling is about people, not just processes. Conducting regular, context-rich reviews that consider both quantitative metrics and qualitative feedback helps foster a culture of continuous improvement. Use the data as a starting point for a conversation, not the final word. Ask questions to understand the context behind a difficult call or a dip in performance. This holistic approach shows your team that you see them as whole people, not just a collection of stats, which is essential for building trust and maintaining strong employee engagement.
In claims processing, the pressure to close cases quickly can often feel at odds with the need for thorough, accurate work. It’s a classic tug-of-war. If you push too hard for speed, quality suffers, leading to reopened claims, compliance issues, and unhappy customers. But if you focus only on perfect quality without an eye on efficiency, backlogs grow and operational costs climb. The good news is that you don’t have to choose one over the other.
Achieving a healthy balance between speed and quality isn’t about finding a perfect, static middle ground. It’s about creating a system where efficiency and accuracy support each other. When your team has the right information at their fingertips and clear processes to follow, they can work faster without cutting corners. Likewise, when quality is built into your workflow from the start, you reduce the rework and escalations that slow everything down. This integrated approach transforms the dynamic from a trade-off to a partnership, where high-quality work naturally leads to faster resolutions. By implementing smart strategies and using the right tools, you can build a claims handling process that is both fast and reliable, keeping your team productive and your customers satisfied.
Setting unrealistic goals is one of the fastest ways to hurt both speed and quality. When claims handlers feel pressured to meet impossible targets, they’re more likely to make mistakes, miss important details, or burn out. Instead of aiming for huge, sudden leaps in performance, focus on setting achievable goals based on solid data.
Look at your team’s past performance data and compare it with industry benchmarks to establish a reasonable baseline. From there, aim for small, steady improvements, like a 5% to 15% increase in closure rates over a quarter. This approach makes progress feel manageable and encourages sustainable habits. A talent management framework can help you track this progress and tie individual goals to the bigger picture, ensuring everyone is moving in the same direction without sacrificing quality for speed.
Many leaders think KPIs are the problem, but the real issue is often how they’re used. The most effective claims organizations find a way to be both fast and accurate by building quality directly into their workflows. Instead of waiting until the end of the process to catch errors, establish quality checkpoints at critical stages of the claims journey. This could be a peer review before a payment is issued or an automated system flag for unusual claim details.
These checkpoints act as a safety net, catching potential issues before they become major problems. By integrating Connected Quality Assurance into your daily operations, you make accuracy a shared responsibility, not just an afterthought. This proactive approach reduces rework and ensures that even when your team is working quickly, they’re still meeting high standards for accuracy and compliance.
A well-trained team is an efficient team. When your claims handlers are confident in their knowledge and skills, they spend less time searching for answers or second-guessing their decisions. Continuous training is essential for maintaining this confidence, especially as regulations, policies, and systems change. A modern Learning Management system can significantly shorten the learning curve for new procedures and help maintain consistency across your team.
Link your training directly to performance data. If you notice a specific type of claim is taking longer to process or has a higher error rate, you can assign targeted micro-learning modules to address the knowledge gap. This data-driven approach ensures your training efforts are relevant and effective, helping your team work smarter, not just harder.
Averages can be misleading. An overall average for claim handling time might look great, but it could be hiding significant delays in a specific product line or with a particular type of complex claim. Relying only on high-level metrics means you could be missing critical opportunities for improvement and leaving your team to struggle with hidden bottlenecks.
To get a true understanding of performance, you need to break down your KPIs. Analyze your data by claim type, handler, team, or any other relevant category. This detailed view helps you pinpoint exactly where the issues are. For example, you might discover that one handler excels at a certain claim type and can mentor others. These specific insights are the foundation of effective, Dynamic Coaching that addresses root causes instead of just surface-level symptoms.
Setting performance metrics is one thing; consistently meeting them is another. Even the most well-defined KPIs can feel out of reach when teams are up against common operational hurdles. Understanding these challenges is the first step toward building a more resilient and effective claims handling process. These aren't signs of a failing team, but rather opportunities to refine your strategy, support your people, and implement better systems.
When every team leader has a slightly different definition of a "quality" interaction, claims handlers are left guessing. This lack of consistency is a major hurdle. Without a single source of truth for procedures and evaluation criteria, it’s impossible to measure performance fairly. This ambiguity can cause confusion and frustration, as handlers receive conflicting feedback and struggle to understand what’s expected of them. Creating clear, documented standards through a centralized Knowledge Management system ensures that everyone is working from the same playbook, making metrics more meaningful and achievable.
Many organizations face pressure to reduce operational expenses, which can lead to leaner teams and hiring less-experienced staff. While this may seem like a short-term solution, it often creates long-term performance issues. Newer claims handlers require robust training and ongoing support to become proficient, and without adequate resources, they may struggle to meet key metrics like First Call Resolution and Average Handling Time. This puts extra pressure on senior staff, who may have to pick up the slack, further straining the team. Investing in effective onboarding and continuous learning through a dedicated Learning Management platform is essential to equip new hires for success and support the entire team.
A disengaged claims handler can have a direct, negative impact on customer satisfaction and processing efficiency. As one expert notes, "A frustrated employee leads to poor claims management." When handlers feel overwhelmed, undervalued, or disconnected from their work, their motivation wanes, and performance metrics inevitably suffer. High workloads, a lack of recognition, and inconsistent coaching can all contribute to burnout and low morale. To counter this, leaders must focus on creating a supportive environment where employees feel heard and have opportunities for growth. Implementing fair, transparent Engagement Tools and providing regular, constructive feedback can make a significant difference in keeping your team motivated and focused.
Sometimes, the biggest barrier to meeting performance targets isn't the person, but the process. Outdated systems, clunky workflows, and siloed information can create bottlenecks that slow down the entire claims lifecycle. For example, if a handler has to toggle between three different applications to find the information needed to resolve a claim, their handling time will naturally increase. Without streamlined processes, urgent claims risk misclassification, which can cause delays and erode customer trust. These operational inefficiencies are frustrating for employees and damaging to the customer experience. Identifying and addressing these systemic issues is critical to empowering your team to work efficiently and meet their performance goals.
Tracking performance metrics effectively requires more than just a spreadsheet. To truly understand what’s happening on the floor, you need tools that bring your data to life, helping you spot trends, support your team, and make informed decisions without getting lost in the numbers. The right technology stack doesn't just show you what happened; it helps you understand why it happened. These systems work together to give you a complete picture of individual and team performance, turning raw data into a clear path for improvement. When you have the right tools in place, you can spend less time digging for information and more time focusing on what really matters: developing your people. A comprehensive performance management system integrates these different functions, creating a single source of truth that empowers both leaders and claims handlers to achieve their best work.
At the end of the day, improving claims handling is about supporting your people. A dedicated performance management platform acts as a central hub for tracking all your key metrics. It helps you monitor individual and team progress, ensuring that your claims handlers are hitting their targets and delivering the high-quality service your customers expect. Instead of juggling multiple reports, these platforms consolidate data to give you a clear, at-a-glance view of performance, making it easier to identify who is excelling and who might need a bit more support.
Great leaders need great tools to guide their teams and maintain high standards. Connected quality assurance software is essential for monitoring the quality of your team's work and their adherence to company procedures. These tools go beyond simple pass-fail scores, providing deep insights into interactions so you can understand the context behind the metrics. This allows you to pinpoint specific areas for improvement, ensure compliance, and provide targeted feedback that helps your claims handlers grow their skills and confidence. It’s about building a consistent, high-quality claims experience.
Data is only useful if you can understand it. Analytics and reporting tools transform complex performance data into straightforward, visual reports and dashboards. These tools are critical for tracking your most important metrics over time and identifying areas where you can make meaningful improvements to your claims processing workflow. With clear reporting, you can easily spot bottlenecks, celebrate wins, and share progress with your team and leadership. This helps everyone stay aligned and focused on the goals that matter most to the organization.
Your claims data likely lives in several different places, from your CRM to your core claims management system. Data integration systems are the glue that holds your tech stack together, enabling a seamless flow of information between platforms. By connecting your various systems, you create a single source of truth for performance data. This unified view allows for much more accurate and comprehensive monitoring of claims handler performance. It ensures that when you sit down for a coaching session, you have the complete picture, not just a single piece of the puzzle.
Tracking metrics is only half the battle. The real transformation happens when you use that data to guide and develop your team. Effective coaching turns performance insights into tangible skill improvements, helping your claims handlers feel more confident and capable in their roles. Instead of just pointing out what’s wrong, a strong coaching culture focuses on building people up, which leads to better claims outcomes and a more engaged workforce. By connecting performance data directly to development opportunities, you create a clear path for every team member to grow and succeed. This approach not only addresses immediate performance gaps but also fosters long-term professional development and loyalty.
Performance data gives you a clear map of where your team excels and where they need support. When a claims handler’s metrics show a longer average handling time or lower CSAT scores on specific claim types, you can move beyond guesswork. These insights allow you to pinpoint exact skill gaps. A great coaching program uses this information to create personalized development plans. Instead of generic training, you can offer targeted sessions on de-escalation techniques, complex policy interpretation, or system usage. This data-driven approach ensures that your coaching efforts are focused, efficient, and directly address the root cause of performance issues, leading to faster and more meaningful improvement.
Consistent, constructive feedback is the engine of continuous improvement. A one-off annual review is rarely enough to create lasting change. Instead, build a culture of regular check-ins and feedback sessions. Use QA scores and other metrics as a starting point for supportive conversations about what went well and what could be improved. An effective feedback loop allows claims handlers to understand their strengths and receive clear, actionable advice for development. When feedback is timely and specific, it empowers employees to make immediate adjustments. This ongoing dialogue builds trust and shows your team that you are invested in their success, which is a cornerstone of a strong quality assurance framework.
Great coaching connects problems with solutions. When a performance metric reveals a knowledge gap, the most effective next step is to guide the handler to the right information. Integrating your coaching program with your knowledge management system makes this seamless. For example, if a handler struggles with a specific compliance procedure, a coach can assign the relevant knowledge base article as a refresher. This direct link between a performance issue and the learning content needed to resolve it makes training more targeted and efficient. It empowers handlers to find answers independently and ensures they are always equipped with the most current and accurate information.
A claims handler is more than just their QA score. The most effective coaching programs look at the whole person, considering their career aspirations, attendance, and overall engagement alongside their performance metrics. This holistic approach recognizes that personal and professional growth are intertwined. A manager who understands an employee’s long-term goals can frame feedback in a more meaningful way, connecting today’s performance to tomorrow’s opportunities. By supporting their overall talent development, you do more than just correct errors; you build a stronger, more resilient, and more motivated team that is prepared to handle the evolving demands of the industry.
Tracking metrics is only the first step. The real magic happens when you use that data to build a stronger, more capable team. Consistent, targeted training is the bridge between identifying performance gaps and actually closing them. It’s not just about onboarding new hires; it’s about creating a culture of continuous improvement where every handler feels equipped to meet their goals and adapt to new challenges. Effective training programs don't just teach procedures, they build confidence and critical thinking skills that are essential for navigating complex claims scenarios. This proactive approach to development shows your team you're invested in their success, which can significantly improve morale and reduce turnover.
When you invest in developing your team, you’re directly investing in better outcomes. Well-trained handlers are more efficient, make fewer errors, and provide a higher level of customer service. This translates into improved closure rates, higher CSAT scores, and lower claim processing times. The key is to move beyond generic training and focus on specific strategies that address the real-world complexities of claims processing. By focusing on areas like technology adoption, customer interaction, and procedural consistency, you can create a learning environment that drives measurable results across all your key performance metrics.
AI is changing the game by helping insurers flag high-risk fraud cases early and identify complex claims that need a senior adjuster’s attention right away. But these tools are only effective if your team knows how to use them. Training should focus on teaching handlers how to interpret AI-driven recommendations and integrate them with their own professional judgment. The goal isn’t to replace your team’s expertise but to enhance it, allowing them to make faster, more informed decisions. This approach helps handlers prioritize their work, ensuring that the most critical claims get the attention they deserve from the start.
Modern claims organizations are embracing technology to enhance efficiency and optimize outcomes. Workflow automation is a huge part of this, as it handles repetitive administrative tasks and frees up your handlers to focus on more complex problem-solving. To get the most out of these tools, your team needs training on how the automated systems work and how their role fits into the new process. A great way to do this is by delivering targeted micro-learning modules through a Learning Management system. This ensures everyone understands how to leverage automation to streamline their work and contribute to a more efficient operation.
For a customer, the claims process is the ultimate moment of truth. A handler’s ability to manage this interaction with empathy and professionalism has a massive impact on customer satisfaction and loyalty. That’s why training must go beyond technical skills and include a strong focus on customer service excellence. Programs should equip handlers with the soft skills needed to navigate challenging conversations with confidence and compassion. When your team feels supported and well-prepared, they are far more likely to create positive experiences, which is directly reflected in your CSAT scores and retention rates.
Consistency is crucial in claims handling, especially for ensuring regulatory compliance and a smooth customer journey. Standardized procedure training ensures every handler approaches similar claims in the same way, reducing errors and improving fairness. For new adjusters, this is especially important, as it shortens their learning curve. The foundation of this consistency is a centralized, easy-to-use Knowledge Management system. Training should teach handlers not just the procedures themselves, but how to quickly find the correct, version-controlled information when they need it most, directly improving First Call Resolution and QA scores.
Tracking metrics for the sake of tracking is just busywork. The real power comes from ensuring that the KPIs you monitor for your claims handlers directly connect to the larger strategic goals of your organization. When your team’s performance metrics are aligned with company objectives, everyone understands how their individual contributions help move the business forward. This creates a clear line of sight from daily tasks to long-term success, ensuring that every action is purposeful and drives meaningful results. It transforms performance management from a simple evaluation tool into a strategic driver for the entire claims department.
Before you can select the right metrics, you have to know what you’re aiming for. Start by defining what success looks like for your organization. Is the primary goal to process claims faster than any competitor? Or is it to achieve the highest customer satisfaction ratings in the industry? According to VCA Software, you should "start with a clear goal (like faster claims or better underwriting)." Once you have that high-level objective, you can work backward to identify the key results that will get you there. This clarity is the foundation of an effective performance strategy, ensuring that your team’s efforts are always focused on what matters most.
With clear objectives in place, you can choose KPIs that directly measure progress toward them. The key is to be selective. Instead of tracking dozens of metrics, focus on the vital few that are most relevant to your goals. A great framework to use is the SMART criteria, ensuring each KPI is Specific, Measurable, Attainable, Relevant, and Time-bound. For example, if your objective is to improve the policyholder experience, metrics like Customer Satisfaction (CSAT) and First Call Resolution (FCR) are far more relevant than internal processing speeds. This targeted approach helps you focus on what truly drives performance.
Aligning metrics with goals isn’t a set-it-and-forget-it activity. Business priorities can shift, and your performance metrics need to adapt along with them. Make it a practice to regularly review your KPIs to ensure they are still relevant and driving the right behaviors. As one industry expert notes, "regularly reviewing and analyzing the claims process to identify inefficiencies and areas for improvement can further enhance processing speed." If you notice that a certain metric is no longer providing valuable insights or is leading to unintended consequences, don’t be afraid to adjust it or replace it with a more effective one.
The data tells you what is happening, but your team can tell you why. To get the full picture, you need to engage your claims handlers, team leaders, and other stakeholders in the conversation. They are on the front lines every day and have invaluable context that numbers alone can’t provide. By talking to your staff, you can "understand the real reasons behind the data." This feedback loop not only helps you refine your metrics but also fosters a culture of collaboration and continuous improvement, turning performance data into productive coaching conversations.
Setting up performance metrics is a great first step, but it's just as easy to get it wrong. When implemented poorly, metrics can create confusion, demotivate your team, and fail to produce any real change. The key is to be intentional about not just what you measure, but how you measure it and what you do with the information. By sidestepping a few common mistakes, you can build a measurement framework that genuinely supports your team and drives meaningful results.
It’s tempting to track everything, but this often leads to metric overload. As one report notes, "Tracking too many metrics can lead to confusion and disengagement. People stop paying attention if there are too many numbers." When your team is swamped with data, they lose sight of what’s truly important. Instead of drowning them in numbers, focus on a handful of core metrics that directly align with your most critical business goals. This clarity helps everyone understand the definition of success and keeps them focused on the activities that make the biggest impact on performance.
Data is only useful if it leads to action. Every metric you track should be paired with a clear plan for what to do with the information. If a claims handler’s average handling time is high, what’s the next step? Simply pointing out the number isn’t helpful. Instead, you need a process that connects that data point to a specific solution, like targeted training or a workflow review. Effective Dynamic Coaching turns performance insights into concrete development plans, giving your team the support they need to improve. Every KPI should have a clear path to success.
Metrics can feel punitive if they aren’t handled with care, which can quickly damage morale. As many quality managers know, keeping teams motivated while preventing burnout is a constant challenge. To avoid this, frame performance data as a tool for growth, not criticism. Use metrics to start constructive conversations about development and to celebrate achievements. Incorporating Engagement Tools like gamification or peer recognition can also help create a positive environment where employees feel supported and invested in their own success. When your team sees metrics as helpful, they’re more likely to stay engaged.
Your business is always evolving, and your measurement process should, too. A "set it and forget it" approach won't work long-term. It’s important to create a sustainable system by "regularly reviewing and analyzing the claims process to identify inefficiencies and areas for improvement." Schedule periodic reviews of your KPIs to ensure they are still relevant and driving the right behaviors. A strong Connected Quality Assurance program can support this by providing the consistent data needed to make informed adjustments. This creates a culture of continuous improvement where your team and processes are always getting better.
Which metrics should I focus on first if I'm just starting out? If you're new to tracking performance, it's best to start small to avoid overwhelming your team. I recommend beginning with one metric that measures efficiency and one that measures quality. For efficiency, First Call Resolution (FCR) is a great choice because it reflects both operational smoothness and a positive customer experience. For quality, start with internal Quality Assurance (QA) Scores. This combination gives you a balanced view of performance, helping you understand if your team is working both quickly and accurately.
How can I introduce these metrics without making my team feel like they're being micromanaged? The key is to frame metrics as a tool for support and development, not for punishment. Be transparent from the beginning about what you're measuring and why it matters for the team's success and the company's goals. Emphasize that the data will be used to identify opportunities for coaching, celebrate great work, and make processes easier for everyone. When your team sees that metrics lead to constructive conversations and real support, they are much more likely to embrace them.
My team is hitting their speed targets, but quality is slipping. What's the first step to fix this? This is a common challenge, and it's a clear sign that the balance is off. The first step is to use your quality assurance data to investigate the root cause. Look for patterns in the errors. Are they happening on a specific type of claim or with a certain procedure? Once you pinpoint the issue, you can provide targeted coaching or update your knowledge base to address the gap. It may also be a good time to review your speed targets to ensure they are realistic and not inadvertently encouraging rushed work.
What's the difference between a QA score and a CSAT score? Think of it as an internal versus an external perspective. A Quality Assurance (QA) score is an internal measurement that evaluates whether a handler followed all the correct procedures, policies, and compliance guidelines. A Customer Satisfaction (CSAT) score, on the other hand, is an external measurement of how the customer felt about their interaction. You need both because a handler can follow every rule perfectly for a high QA score but still leave a customer feeling unheard, resulting in a low CSAT score.
How often should we review performance metrics? Effective reviews happen at different cadences. Your claims handlers should have access to their own performance on a real-time dashboard so they can self-correct throughout the day. As a leader, you should be holding brief, informal check-ins weekly to discuss trends and offer support. More formal, in-depth coaching sessions based on performance data are most effective when held every few weeks, while team-wide reviews of progress toward major goals can happen monthly.
Insightful Analysis on Contact Center and Customer Support Trends
Check out our eBook, New Thinking About an Old Problem
Join contact center and customer support professionals around the world who can’t wait to see the C2PI every quarter.
300 Colonial Center Drive, Suite 100
Roswell, GA 30076
Copyright © 2025 C2Perform. All Rights Reserved. Privacy Policy Acceptable Use Policy
English
Español
