Build the team around a shared intake standard, clear production ownership and a calibrated acceptance function. Do not simply move existing estimating staff into one reporting line and assume the workflow has been standardised.
A practical design should specify:
- Intake ownership: who checks that required evidence is present and who obtains missing information.
- Production lanes: which files are routine, specialist or unsuitable for central production.
- Rule ownership: who approves carrier guidelines and resolves conflicts.
- QA responsibility: who checks the work and who adjudicates reviewer disagreements.
- Decision authority: which claims decisions remain outside the production team.
- Capacity management: who owns queue ageing, reassignment and surge support.
Require a shared defect log and recurring calibration sessions using actual redacted examples. Track whether reviewers agree on the defect, severity and correction—not just whether they return the file.
Crawford’s reviewer role illustrates the combination of construction knowledge, client-specific rules, documented revisions and adjuster communication involved in review work. Use those activities to inform competency requirements, without treating one employer’s role description as a staffing benchmark. (fa-esau-saasfaprod1.fa.ocs.oraclecloud.com)
For headcount planning, use measured productive hours and case-mix-adjusted workload. Do not derive capacity from salary, job title or nominal eight-hour availability alone.
Sources cited on this page
- fa-esau-saasfaprod1.fa.ocs.oraclecloud.comfa-esau-saasfaprod1.fa.ocs.oraclecloud.com