There’s no doubt that the claims profession is continuing to grapple with the loss of seasoned employees to retirement. While the Boomer generation has exited the workforce for the better part of a decade, carriers have continued to seek new talent.
Replacing long-term, knowledgeable claims teammates requires an investment in effective hiring practices to attract a new generation of claims specialists. Just as important is the approach to onboarding and training, a factor many new hires see as critical to how long they remain at their employer.
For a new Claims Specialist (CS), acquiring the foundational skills through formal training is only the beginning. The real learning occurs when those skills and behaviors are implemented during the management of live claims. With the right structure in place, a new CS can quickly gain comfort and confidence which will increase job satisfaction and contribute to the company goals more quickly. Without this investment in structure, the learning curve can be extended, the CS may become frustrated and additional errors and rework impacting customers and the business may occur.
Prioritizing a mentoring approach means focusing on the right quantity and quality of resources committed to this task. . Carriers who provide dedicated coaching/mentoring resources and develop processes for ongoing feedback position themselves for success.
Key Roles and Expectations for Onboarding Success
Creating a formalized mentoring plan that provides transparency and accountability for each stakeholder can be useful for ensuring the process is most efficient and productive. The key is having clear expectations of each role relative to the development of the claim specialist.
Three primary roles are involved in the optimal development of the claim specialist: the supervisor, a mentor (more experienced teammate) and the claim specialist themselves. When these roles work together effectively, it can build the specialist’s confidence more quickly, resulting in their proficiency more quickly and requiring less support in the long run.
- The claim specialist must take accountability for his/her learning and soliciting feedback.
- The supervisor establishes performance expectations (i.e., what is expected at certain milestones) and monitors the claim specialist’s progress against those expectations. If the claim specialist is not progressing as planned, the supervisor should intervene as appropriate.
- The mentor provides day-to-day technical support to the claim specialist. This includes answering questions, reviewing the claim specialist’s work, providing feedback and providing status updates to the Supervisor.
Claim Specialist
The first priority for the CS is to be accountable for increasing their knowledge after completing training. The goal is to demonstrate effectiveness and efficiency through skills and behaviors. The CS should ultimately own their progress, soliciting and responding to feedback and coaching from more experienced teammates, identifying gaps in progress and taking proactive action to close them.
Role Expectations
- Negotiates specific time to connect with the mentor as appropriate.
- Solicits feedback on progress and performance from the mentor and unit leader. Listens openly and objectively.
- Applies learned skills and behaviors to new situations.
- Takes reasonable risks utilizing natural curiosity and moves beyond his or her natural comfort zone.
- Consults training materials or documented policies and procedures before asking the mentor a routine question.
- Ensures he or she is clear about developmental and performance expectations.
- Takes ownership for understanding what is expected and meeting those expectations.
- Develops and maintains an actionable developmental plan.
- Proactively solicits support from others to complete the plan.
Business Unit Supervisor
The unit leader establishes individual CS expectations and monitors progress against them and the organization’s larger goals and objectives.
Additionally, the unit leader should offer coaching and support to the CS while holding him or her accountable for meeting development and performance objectives. Through these behaviors, the unit leader can reduce the CS’s time to full proficiency in the role.
Role Expectations
- Communicates organizational priorities, expectations and general information through one-on-ones with the CS or during staff meetings
- After a formal recommendation from the mentor, decide that the CS has demonstrated the skills required to be granted authority.
- Conducts formal bi-weekly or monthly one-on-one meetings with the CS, discussing the CS’s business indicators, productivity, QA scores, feedback from resources, etc. The unit leader also discusses the CS’s progress towards proficiency and offers support as appropriate. All these discussions are framed within the context of performance expectations.
- Establishes CS caseload levels (new claims per week and open claims)
- Solicits feedback on the CS as appropriate
- Conducts CS file reviews and directly observes the CS in key settings (multi-disciplinary forums, clinical walk-ins, vocational walk-ins, etc.), may monitor CS claimant telephone interviews.
- Clarifies organizational policies and practices as appropriate
- Decides when the CS has met the criteria for first-pay authority and promotions
Mentor
The mentor provides continuing technical support, feedback and coaching to the CS after completion of training. Until the CS achieves first-pay authority, the Mentor should review and approve most of the significant activities performed by the CS.
The mentor may continue to play a technical support role to the CS after he or she has been granted first-pay authority. This support may continue up to and beyond the point at which the CS has achieved full proficiency.
Role Expectations
- Transfers technical knowledge and skills to the assigned CS(s)
- Serves as the first stop for the CS’s questions, explaining both the ‘what to do’ and the ‘why to do it’
- Approves activities outside of the new hire’s authority level
- Monitors the CS’s skill development during through claim referrals and direct observation. Identifies and communicates recommendations to the Unit Leader to facilitate the CS’s progress, including remedial interventions as appropriate
- Provides situational coaching and feedback to the assigned CS
- Observes CS during interactions with specialty resources (e.g., clinical walk-ins, multidisciplinary meetings, vocational walk-ins, etc.)
- Provides input into the unit leader’s decision to grant first-pay authority to the CS
- Provides input into the decision regarding the appropriate new claim volume and open caseload for the CS until he or she reaches a full caseload
- May provide input into the unit leader’s decision to promote the CS
Implementing a Mentoring and Coaching Framework
With the need to attract new claims management talent a top priority for many insurers today, it’s critical to implement a structured mentoring and coaching program to support the onboarding process. At Brown & Brown Absence Services, we advise disability insurers on practices for developing an effective and efficient framework. Contact a representative to learn more.