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2021 Agent – Great Customer Service Improvement Stories

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Top 5 Agent CX Improvement Stories

Improved Resources Lead to Improved Customer Service

“With these changes internally, I feel more confident… and I’ve been able to assist members more effectively”

I have been working with MAPS for the past 21 years! I truly enjoy the feeling I get when I am able to help someone who needs it.

My day-to-day experience on calls with members can be as simple as someone requesting a new identification card, or a member who has a child away from home who needs medical care right away! Listening to my members as they express themselves helps me to gauge whether I need to make an outbound call to help get medical care coordinated, or if I just need to be a helpful ear and empathetic in their moment of need.

Our resources for information have been improved and we have the fabulous new system, Blueview. With these changes internally, I feel more confident as I am working, and I’ve been able to assist members more effectively, without any doubt or hesitation. Part of my biggest challenge as an Associate was feeling like I was not able to rely on the available resources, so, I would often become frustrated, and this affected call experiences.

Thankfully, I have had some great leaders over the past 2-3 years that have cared about me enough to teach me a better way and encouraged me to think outside of my own box. Reflecting on my inner strengths and my weakness has really allowed me to be a much better Associate. I enjoyed learning about myself and felt good when I could hear my calls to see how I could avoid upsetting a member and getting a negative SQM rating.

Gigi McNeil Blue Cross Blue Shield of Massachusetts



Adapting to Call Center Culture, and Buying into the Vision of the Team

“Marquisha had transformed into a world-class advocate right before our eyes!”

Marquisha Jackson has been a Customer Service Advocate in our area for the last 3 years. She began her tenure as a temporary employee who had never worked in a call center job before. Most of her adult employment history consisted of manual labor in different settings. When she came to our service team, she was looking for an additional means to support her family. and did not truly envision a long-term commitment. It took some time for her to adapt to the different culture and atmosphere of our call center. She had to alter her communication style, approach, and patience. Through her previous jobs, she had been conditioned to be task-orientated and less focused on the person she was impacting, either directly or indirectly. She took few chances and played it safe. Her sole goal was to complete the task at hand, head down; she didn’t speak up much just kept grinding away to accomplish her task.

Throughout her tenure with our team, there has always been a light inside of Marquisha. There was something in her that occasionally peeked its head out and exhibited superior customer service skills; it was few and far between, but it was there. After working endlessly through mentoring with her supervisor and managers, working through some difficult conversations with team leads about how to improve her call handling, and with coaching from our dedicated coaching team, we saw Marquisha begin to change. She began to become more and more empowered. She bought into the vision of our team: providing world-class service on every phone call. She exhibited outstanding ownership, accountability, and perseverance. She dug deep within herself on every call to find a way to not only connect with our callers but to think outside of the box to find possible solutions. Marquisha had transformed into a world-class advocate right before our eyes!

In thinking through the transformation of Marquisha, there is one-member interaction that comes to mind which is a great reflection of the endless work that Marquisha has put in to become a superior customer service advocate. Recently, Marquisha received a call from a highly upset member. As soon as the caller came onto the line, it was abundantly clear that he was beyond frustrated and needed help. He was loud, aggressive, and unwilling to let Marquisha speak. She quickly took action and began to acknowledge his clear emotion and take ownership of the issue. She did not shutter at his aggressive language or hurled insults; rather, she saw through this and recognized that she was on the phone with someone who just needed to be heard and helped.  As she was listening to him vent, she quickly reviewed the notes on the account and realized that this member had called in 6 times in the last 3 days! Marquisha knew that she had to send a resounding message to this member that he had connected with the right person and that the proverbial “buck” would stop there. Through her recurring acknowledgment and persuasive verbiage, she successfully took ownership of his issue and got him to agree to let her do some additional research. After much reluctance, Marquisha was able to win him over and have him accept a callback by the end of the day. Although the member had not previously received promised callbacks, he agreed because Marquisha had established a foundation of trust between them through their short interaction.

After ending the call and loading her notes, Marquisha sprang into action! Through her in-depth research, she was able to quickly identify this member was part of a vulnerable population and the root cause of his issue was not only causing him anxiety but financial distress that could be catastrophic if we did not intervene on his behalf. Marquisha was able to gather from previous notes that our member was taken advantage of by another entity that was supposed to help him, and this placed him in a place of distress because he owed several thousands of dollars to a medical provider. This would make any reasonable person highly distressed, but, for this member, not having access to needed medical care was not an option – it would be a death sentence! Marquisha immediately reached out to the other advocate on the team who previously spoke with this member and took over her inquiry. She also notified the supervisor who was involved that she was taking over, and her priority was to get to the bottom of this immediately. Marquisha then engaged the manager of the call center to apprise her of what had happened and how she has prioritized this issue for the member. She communicated the need to resolve this as soon as possible to avoid any further detriment to this member’s health and financial stability. Marquisha was clear, concise, and assertive as to what needed to happen and how quickly it needed to be done.

Marquisha began making calls to all the other entities involved. She began tracking down the reimbursement check (worth several thousand dollars) that one entity received, cashed, and refused to give back to the rightful owner: our member. Without having this check, the member would not be able to reimburse the medical provider that rendered services and that has refused to continue seeing this member without being paid. Without having access to the funds from this check, the member was doomed. When Marquisha didn’t get the answers she needed, she kept escalating; she continued to call the provider’s office to ensure the appropriate parties knew the situation and documented the member’s information to prevent any further collection efforts or refusal of services. Marquisha had taken on the role of true advocate and was working swiftly to resolve this issue.

By the end of the day, Marquisha had successfully gotten the case manager’s superior to rectify the situation and have a new check issued to the member. She had gotten the provider who was due the payment, in excess of $6,000, to update the member’s file and allow the member access to the care he was previously denied. When Marquisha called the member back before the promised call-back time, the member was literally in tears. Up until now, he felt that the world was on his shoulders and did not know what to do next. However, his issue was entirely resolved through the efforts and actions of Marquisha! He could not thank her enough, and he spoke highly of the appreciation he had for her ability to see through everything and realize he was another human who needed help.

Without knowing the path Marquisha has taken since she began her tenure with our service team, this would seem like par for the course thing for a world-class advocate; however, this was a monumental improvement for Marquisha. Her growth has been remarkable! She allowed herself to become vulnerable and trust the process. She listened and allowed herself to implement the feedback and suggestions provided to her. While she is amazing on any day, this member interaction truly highlights Marquisha’s noteworthy perseverance. She now confidently embraces all the traits we see in world-class advocates: empathy, accountability, ownership, and sheer tenacity. This member interaction is the most fitting example of why she should be the most improved customer service advocate in the country!

Marquisha JacksonBlueCross BlueShield of South Carolina



Focusing on First Contact Resolution Leads to World Class Performance

“Going above and beyond is something that Bridgett does daily.”

Bridgett has a passion for providing excellent customer service on every call. Bridgett is part of our Medicare Center of Excellence Call Center and answers our members’ questions, including: what their plan covers, is their provider in the network, what is their copay for a visit, and what is their responsibility on a claim. As much as she enjoys talking with our members, she also enjoys educating our members on how to self-service through a digital experience.

In 2020, Bridgett’s World Class Call percentage was 82%, which wasn’t a number that Bridgett was satisfied with, nor did it represent what she does every day as a Customer Service Professional. She set a goal for 2021 to provide world-class service to every member she spoke to. Bridgett took her passion for customer service and committed to treating every caller like a family member, assisting them in any way she could. With Bridgett’s knowledge of the Medicare product, she focused on resolving member questions in one phone call – First Contact Resolution. She knew there were times when she couldn’t accomplish this, and she would set realistic time frames for the follow-up with her members. Bridgett used tools and resources to make sure she was providing accurate information and looked to identify any downstream issues that might affect our members.

Bridgett receives many kudos from the members she interacts with. One member recognition that stands out is when she spent 45 minutes with the member going over a list of questions. The member was very complimentary about how she went above and beyond. She never felt as if she was a burden. Bridgett was friendly, professional, and compassionate throughout the entire call. Going above and beyond is something that Bridgett does daily. She loves what she does, and it comes across in her interactions.

Through Bridgett’s dedication and hard work, she not only achieved the goal she set, but she also exceeded it! She increased her world-class call percentage by 16%, to 98%. This is attributed to the empathy, ownership, and resilience that she displayed during conversations with our members. Bridgett can easily build trust, leading members to feel confident that she sincerely wants to resolve their issues. We are all very proud of Bridgett for striving to be the best she can be and providing world-class service to our members.

Bridgett Kroyer – Regence Blue Cross and Blue Shield Plans



A Service Hero

“She anticipated the member’s needs and embodied the qualities we expect from our representatives.”

Sara Winter has been with Regence BlueCross BlueShield since July 2019, where she was trained to support incoming calls from Members. She handles different types of inquiries, such as checking eligibility, advising benefit coverage, locating providers, updating demographic information, and Web Support.

At the beginning of 2021, and throughout the year, Sara reached out to peers and leaders for feedback regarding her calls. She has a great commitment to learning and growing, and understands the impact she has in her role. Sara has taken feedback and pushed herself to provide great service.

Due to her success with providing a consistently good experience to each of her callers, she was asked to share her success with the team. Sara took the time to create a presentation about the importance of listening to the caller’s needs, and how we can make personal connections with Members. She also created helpful Job Aids with tips and tricks on positive verbiage that everyone can use on their calls. Another leader in our organization heard about this presentation and reached out to Sara, asking if she could present this in their team’s huddle.

Comments from surveys show how Sara is committed to providing a good experience:

“She handled my situation professionally, and quickly. She got to the root of the problem immediately and was very helpful.”

“She was super nice and personable, and just very helpful, overall.”

“The employee was very helpful and very knowledgeable about my question and about my concerns. I was able to quickly find the information she needed to have to help my specific situation. I appreciated her help.”

Sara was nominated for an award with our internal recognition program called Service Hero.

I received a voicemail from a member expressing gratitude for the service Sara provided. The member expressed that she went above and beyond to explain benefits, coverage, and pricing, and explained it all in a way that they could understand. In this call, Sara’s demeanor and professionalism stand out. She was patient with every question and asked relevant probing questions so she could provide the most accurate information. Sara left a lasting impression on our members. She anticipated the member’s needs and embodied the qualities we expect from our representatives.

Because Sara consistently provides excellent service which is reflected in her 2021 World Class rating of 95%, and because she has an improvement score of 21% from the year prior, I’d like to nominate her for the CSR Top Improvement award for 2021.

Sara WinterRegence BlueCross BlueShield Plans



Improving Through Feedback and Support

“The entire team congratulated Sheryl each time she received a World Class survey.”

I started with VSP in the late fall of 2019. I was hired as a part of a new initiative in the Retail Support Center. I was impressed, immediately, with the organization and its desire to help the members, and the extensive support they offer their employees. I had the desire to expand my growth and knowledge of our business and expanded to the Vision Benefits segment of the company.

I come from a background in collections and worked as a paralegal. I know how critical it is to protect customer information and gain the trust of the caller. When I am helping our VSP members, I always try to focus on what is important to the member in that call, and what it is they are trying to accomplish. I try to be professional and knowledgeable while maintaining a comfortable connection with the caller. I believe customers appreciate representatives who are polite, professional, and who have the information they are seeking while being honest enough to get help when they don’t.

When I get a difficult call, I never take it personally. People deal with stress in different ways. I remember you never know who you are talking to, or what they are going through. I stay calm and professional, try to empathize with the member, and offer the best possible resolution.

The feedback and support I continuously receive from my Supervisor have helped me tremendously in improving my call quality. She knows it is important to me to do a good job, and she does not hesitate to communicate feedback to me. With her help, this feedback has allowed me to recognize my strengths, and improve in areas I was lacking.

Every day, every call, I ask myself how I could have handled things better. I check resources, emails, and updates, and ask for help on issues that are unclear to me. I try to answer unanticipated questions before the member hangs up – questions that they may have forgotten to ask – offering information and resources so they don’t have to call back. I always shoot for a one-call resolution. These things, I believe, have led to my SQM improvement.

The following is feedback shared by Sheryl’s Supervisor:

"As Sheryl’s supervisor, I knew one of her goals in 2021 was to improve her SQM results. She is very conscientious and checks her SQM surveys daily. Our team likes to celebrate our World Class surveys as soon as we receive them. I email the team to congratulate the particular CSR and highlight the customer feedback so we can see what made for a World Class experience for the caller. As a result, the entire team congratulated Sheryl each time she received a World Class survey."

"Sheryl wanted to focus on providing each of her callers with a World Class experience. Starting in January 2021, we listened to calls together and talked through ways she could improve customer experience. Sheryl identified opportunities within the call and ways in which she could improve moving forward. Her tremendous improvement from 2020 to 2021 was a result of her determination and focus. I feel fortunate to have Sheryl on my team!"

Sheryl Wilkerson – VSP Vision Care