SQM Group

2020 Top CSR CX Improvement Stories


Focused on Creating Strong Customer Engagement

“Your company is lucky to have her!”

Keri Bonin has been a member of the Commercial Member Call Center for a little over three years. She began her career at Blue Cross Blue Shield of Rhode Island as a temporary employee, and quickly became a permanent employee.

Keri’s attention to detail and eagerness to excel led to her being promoted to her current position within the Call Center, as a Tier 2 agent.

Keri has achieved an overall improvement of 19% for World Class Calls in 2020.

Keri is committed to improving the customer experience to make Blue Cross Blue Shield of Rhode Island the insurer of choice. To achieve this improvement, Keri has focused on creating strong customer engagement by going beyond the scope of her job description to make sure customers’ concerns are heard and addressed. Customer feedback regarding Keri’s assistance include the following:

  • “Keri was very clear. She helped me figure out what was going on. She was able to help me contact the doctor and make sure everything was resolved.”
  • “Keri was absolutely fabulous! She went above and beyond to resolve an issue for me. I did not have to do anything. She did everything while I was on hold. Your company is lucky to have her! I don’t want her to go unnoticed so shine a light on her!”

Keri follows through on requests, communicates information, and provides solutions to problems in a timely fashion, as evidenced by another accolade from a member:

  • “Keri returned calls as promised. She followed up, and was 100% on top of it.”

She can build customer confidence, as evident from accolades received by our members.

Because of our members’ satisfaction with speaking with Keri, I would like to nominate Keri Bonin as a rising star for the CSR Top Improvement award for 2020.

Keri Bonin – Blue Cross Blue Shield of Rhode Island

 


 

Going Above and Beyond to Care for Members

“Jenna has been a ray of sunshine… She made a big impact on me today for the positive!“

Jenna joined HealthNow New York Inc. in June of 2019. Jenna really embraced SQM in 2020; she received both the World Class Certified and Top Improvement recognition. These accomplishments were achieved due to Jenna’s perseverance and passion. She improved by 21% in 2020 for Top Improvement, going from 69% to 90%! This is an amazing accomplishment which we are very proud of. Jenna worked very hard in 2020 to improve her overall scores, taking it upon herself to improve by asking her Supervisor for feedback. Jenna even reached out to other coaches and trainers for feedback on how to improve. She has always made it her goal to exceed expectations and do whatever was necessary for her customers. Jenna always goes above and beyond to take the members out of the loop, and she takes her time with each member to ensure she resolves their issues.

Here are a few member comments showing how hard Jenna has worked:

  • “I had a hard situation to grasp, and it was difficult to go through. I wanted to thank her for the help and for being so kind. Good help nowadays is hard to come by, and I greatly appreciate the kindness, and accurate and fast help that she gave.”
  • “I had an excellent experience with Jenna today. I have been in customer service for over 40 years and Jenna has been a ray of sunshine, she was the most respectful, pleasant, and kind person that I have spoken to in the medical field. Jenna was patient and understanding and answered every question for me She made a big impact on me today for the positive!“

Here are a few member comments from her SQM surveys which will attest to the fact that she goes above and beyond, and really cares for our members:

  • “She was very patient, very knowledgeable, very respectful, and well mannered. She is just, all around, a good person to have in your company.”
  • “I mean, she answered all of the questions that I had, she took her time, and she was extremely polite and thorough.”
  • “She was very professional and also talked through the steps she was taking to resolve my issue.”
  • “She was very friendly, informative, and she took care of what I needed very quickly.”

Jenna has only been with us a short time, and she has really thrived. She worked very hard to turn her performance around, and to make a great impression with our members. Jenna ends every call with “Have I met your expectations on our call today?” She enjoys the feedback she receives from her calls and uses it to improve herself on future calls. If Jenna has an irate member, she takes it as a challenge to turn that caller around by the end, turning it into a positive call.

We truly feel that Jenna is deserving of this award, she is a true example of what we want in an employee and a person we want helping our members.

Jenna Albertine – HealthNow New York Inc.

 


 

Restoring Members’ Trust and Giving them Hope

“Each Customer Service interaction has become more than just a phone call. It has become an act of love.”

When I first started, I knew this job would be a challenge. However, nothing could have prepared me for the truth of just how challenging it truly would be. But there are some times when a call just sticks with me and pushes me; it teaches me about myself, and about what it means to be a Customer Service Professional.

Looking back at my first call with an angry member: it left me stumbling over my words, feeling frazzled, and matching their irritation. While, at first, it seemed like a good idea at the time, it always ended with them calling back again, angrier still that their problem was unresolved. Over time, I learned that reacting with patience and understanding, and the knowledge that the member was not upset with me, but instead with the situation they found themselves in, went a lot further than providing a quick answer and rushing them off the phone.

When these calls are handled properly, thoroughly researched, and treated with empathy, Customer Service Professionals can restore a member’s trust and give them hope that there are still people who will do the right thing.

But not every caller is angry. Sometimes they are facing an impossible issue with no solution in sight. I remember working closely with a member who had no out-of-area coverage. She contacted Customer Service, confused and nearly in tears, after finding out that the claims related to her heart surgery had been denied because the provider was out-of-area, but she had received the services within her coverage area. Hearing her worries, I assured her I would do everything in my power to assist and set about the task. After much effort, I was able to facilitate the processing of her claims and had the pleasure of letting her know we had resolved the issue. The relief in her voice made all the struggles I faced in serving her worth it. I got to share in the beauty of getting to know her. For me, she has become a person I think of often. She became more than just another person on the other end of the line, she became a friend, and the experience we shared taught me that having persistence can yield great results.

The calls that are the hardest for me, but often mean the most, are the calls where a member is suffering from a broken heart. These calls come in many forms:

A spouse calling to let us know that our member, and their companion of 60 years, has passed away. Struggling to wrap their head around living without someone they never imagined losing. Wanting to share a moment and remember their wife fondly. Hoping for a warm heart to embrace them for a moment.

A parent calling about cancer treatment for themselves or for their young child. Needing to understand their benefits and wondering if they will survive. Needing a safe space to discuss their worries, with someone to listen and allow them to cry.

A member calling for a reinstatement, who gives in to her grief and shares that her husband had passed away a few months ago. He handled everything and now, in her 70s, she’s learning how to pay bills and manage her finances on her own. Learning to function without him, having never imagined the need to.

Each of these calls require special care and a willingness to give of yourself. These heartbreaking experiences remind me that having compassion and empathy for others may seem like a small effort, but can still make a difference in the lives of another.

Whether it is slowing down and digging in with the member to find the root cause of the issue, persevering when the odds of making it right are against you, or providing a listening ear, you can make a difference to the person on the other end of the line. For me, each Customer Service interaction has become more than just a phone call. It has become an act of love.

 

Clarece Haney – Regence Blue Cross and Blue Shield Plans

 


 

Effort to Improve and Fulfill His Potential

"Your Organization is fortunate to have him, and we hope that… he can be an example for all of the Security Health Plan organization.”

Richard Merkel has been with Security Health Plan since 2015. He started out as a temporary agent assisting through our Annual Enrollment Period during our busy 4th quarter season. Richard eventually became a permanent agent and began training on our other main product lines. Training on additional product lines brings additional challenges for agents, as there is a lot of information to know when working as a cross-trained agent.

When we look at a CSR for improvement, we like to combine their SQM survey data, along with their internal quality. Richard had not achieved World Class status in 2019. He had received coaching in areas where he was struggling, and goals were put in place so that he was aware he wasn’t quite meeting our expectations. He was given the tools and best practices to change his handling practices. We believed in Richard’s potential and knew the service he was providing was not up to our standards.

Richard does a phenomenal job connecting with members and making them feel comfortable. At times, he can come across as too relaxed which isn’t always ideal on a professional level. In early 2020 Richard and his manager reflected on his passion for helping members, and the need to match his quality audit scores.  His call coach provided feedback and tips, while also comparing outcomes to where he had the potential to be, versus the scores he was obtaining. By mid-year 2020 there was noticeably a significant improvement in Richard’s call handling and audit scores. He really took the advice from his supervisors to heart. He wanted to do better and proved it in the coming months.

When receiving coaching feedback, Richard is open and honest about how he feels about the audit process and gives ideas for process improvement.  When he realized that a couple of necessary pieces that he was missing during calls were factors in his quality audit average being below his potential, he made a decision to start incorporating those items into his calls. He was determined to make the necessary changes to work towards improving his stats. His call coach worked with him a lot throughout 2020; she would check in on him, and use positive reinforcement every time he received a good survey and a good quality audit. His coach was bound and determined to help Richard succeed because she knew his potential.

Beginning in April of 2020, there was a positive shift across the board for Richard. When combining the SQM survey stats and Security Health Plan’s quality information, Richard was only averaging around 84% from January-April of 2020. He finished out May-December 2020 with an average of 93%. This was almost a 9% increase over 2019, where he averaged only 84%. Our department expectations are that agents reach 92% or above. Looking solely at the SQM World Class measure, Richard had a 12% increase from 2019 (78%) to 2020 (90%). This was such a phenomenal increase, and everyone was so proud of how Richard completely turned his scores around. Richard’s Call Resolution percentage increased by 8% from 2019 (85%) to 2020 (93%).  Richard’s FCR also saw a 10% increase between 2019 (71%) and 2020 (81%). Additionally, he saw a 2% increase in CSR CSat between 2019 (90%) and 2020 (92%). Seeing these positive changes for Richard, in just one year, really solidifies how important our coaching program is and that positive reinforcement, encouragement, and routine check-ins make a huge difference.  

Richard has an enthusiasm about supporting a high-functioning team.  His strong work ethic to not only keep up with the inbound call volume, but also provide each member with a valuable experience can be felt when you are near him. On a tough day, you will hear or see Richard encouraging team members.  He also does things that would often go unnoticed, such as reaching out in a quick private chat message to a coworker to check on them, or see how they’re handling a heck day, or even a tough time in their life. Richard will also volunteer to take on complex situations from newer CS Reps. Onsite coworkers and supervisors could often hear Richard give a shout out to his nearby teammates.  

Richard has also received recognition from our membership. He was recognized with a Member Experience Award for the way he flawlessly handled a complex member claim situation. Member wrote a letter,

  • “I am writing to commend one of your employees. That person is Rick Merkel and he helped us through a very difficult time. We had a claim that involved out of country coordination. The claim took more than four months to settle. During that time, we talked to many different people. We rarely had contact with the same person more than once. We were beginning to think we would never reach a solution on our claim. We were told our check would be sent. We waited & waited. We finally met Rick who called us back several times and worked with us until the ‘check was in the mail’. Your Organization is fortunate to have him, and we hope that he is a supervisor, and that he can be an example for all of the Security Health Plan organization.”

Beyond supporting his team onsite, he has a heart of gold, which is shown in how he treats people. A little-known fact from a previous coworker of his is that he helped her out during a rough time personally. She was struggling to make ends meet, and Richard would bring snacks or gift cards to help her get by.  He would never say anything about how he goes out of his way for people, but he is a very caring individual. We are lucky to have him on the team.

 

Richard Merkel – Security Health Plan

 


 

Improvement Through Feedback and Coaching

“I hope that I told her how grateful I was, and that she did a great job.”

I started with VSP in 2015 and quickly learned the benefit of making a true connection with members from the beginning of the call. Building rapport at the start of the conversation helps set the pace and establish trust. Some members struggle to convey their needs. Most of the time, I take notes during the call in order to recap with the member a mutual understanding of the situation.

I have had many situations where I have had to make a quick decision for a member. I had one situation where a member called in furious. She was upset that she had a long-standing appointment and the office contacted her to inform her that the benefits were not available; therefore, she needed to reschedule. I could understand her frustration. I assured the member that I would be happy to help with the issue. After confirming with the member where she was going to for services, I reached out to the billing office. I spoke to a billing specialist and learned that the incorrect patient was billed. We worked together to get the claim corrected, moving it to the correct patient. I then reached out to the new office to provide them with the information they needed to prevent the member from having to reschedule. The member was very pleased that I took the extra steps to resolve the problem. Not only was she pleased it was resolved, but she was impressed with how quickly it was taken care of, and that I reached out to her provider to clear up the confusion.  

My daily goal is to do better and to help more than I did the day before. I check my stats and emails daily to stay up to date on any new company changes. Being cognizant of my performance has helped with the improvements in my monthly stats, and in being confident with the information I am providing to the member.

Comments from Heidi’s supervisor:

  • “I became Heidi’s supervisor in mid-2019. Heidi had been with VSP since 2015, but was new to my team. She was very discouraged that she was not going to achieve World Class status for the year 2019. Towards the end of the year, Heidi and I made a commitment to focus on her call handling in 2020 so she could be World Class certified.”

On our team, every World Class survey gets emailed out to the team with the call feedback. As a result, the team receives several emails throughout the day, recognizing their peers for World Class calls while also seeing the feedback from the caller. Heidi started checking her surveys daily and we celebrated each World Class survey. We listened to each call and discussed what she did to make that member “Very Satisfied”. On any survey where the member indicated a rating other than Very Satisfied, we talked through the call. I provided feedback on what she could have done differently which would have resulted in a happier customer. Heidi worked very hard all year to implement feedback from our coaching sessions.

Over the past year, I have seen Heidi become more efficient in her call handling, while also developing a commitment to assisting the member in any way possible. She has been able to show her customers that she cares and wants to help them.

Recently, she had a call where the member was very frustrated by trying to use her VSP plan with her provider. The office could not find her information, and she was frustrated when she called VSP. Heidi was able to calm her down and explain the benefits to her. The member was thrilled when Heidi offered to call the provider and assist them with her VSP ID and an authorization number. The customer shared:

  • "I called VSP today, because my daughter had a test and she needed a new prescription for eyeglasses. When we approached the optical department, we were told we had to take a seat and they would process it for us. They were unable to find my husband's information. We were not able get the prescription because there seemed to be a problem with the information. They said that we did not have a VSP number. I was perplexed because we have been with the same practice for many years. When I arrived home, I called VSP to see if there had been any changes to our coverage. I spoke to, her name is Heidi, she was fantastic. I explained what happened, and she got all the information from me and verified that I indeed do not have a number that I need to present in order to get the benefits. Together we called the practice, actually I think she called the practice and patched me into the call. She was speaking with the optician to find out why we were not getting the coverage we should be getting. Everything was resolved. It turned out that the office had misspelled my husband's name and it was a very simple error. The fact that Heidi stayed with us, and was very quick on trying to diagnose what the problem might be, was very surprising because not all customer service reps are that conscientious. So, I hope that I told her how grateful I was, and that she did a great job. I hope that somehow she gets some recognition for this, because she handled everything professionally."

The feedback from the member was so complimentary of Heidi’s customer service - I was so proud of her!

Overall, Heidi made a 17% improvement in 2020, when compared to her 2019 World Class rating. She ended 2020 with a 93% World Class rating. Heidi was able to make this tremendous improvement due to her ability to stay focused, and remain open to feedback, and because of her commitment to her customers. I am pleased and excited to nominate Heidi Grant for the CSR World Class Improvement recognition.

 

Heidi Grant – VSP Vision Care