After using it for a few days I have discovered that sometimes it refreshes and works exactly as I would expect. 

Yet other times marking a ticket as closed or transferring it, updates the ticket but doesn't refresh the list or the totals. When it is not refreshing if I update a group of tickets and update them then it doesn't let me select a different ticket and I have to refresh. Generally if I delete a ticket this seems to force a refresh. 

Does anyone have any ideas what could be causing this? 

Based on your description, it sounds like you may be having a SignalR issue. This may be caused by spotty connection or issues on the server. We suggest opening a ticket for more personalized support.