2024 Top Agent CX Success Stories

Finalist Success Stories

Amandeep Boparai – 407 ETR

When thinking of SQM’s 2024 Agent of the Year, one person easily comes to mind: Amandeep Boparai. 

Having joined the company in September of 2023 as a Part-Time Customer Service Representative, Amandeep has gone on to be an example of what can be achieved at 407 ETR when you are focused, determined, and work hard to achieve your goals. 

From the start, Amandeep stood out among his peers for being quick-thinking, articulate, resourceful, and for conveying kindness through every single customer interaction. This was quickly noticed by floor support and superiors such as Rachel Mahon, Mark Ganhao, and Brandon Barnewall. 

It became apparent that Amandeep was going to achieve great things at 407 ETR, and as time went on, he continued to flourish.  

When handling customers, Amandeep is a model of how to utilize Ulysses and how to address customer-related inquiries. 

This is demonstrated by his consistent nature in providing World Class Customer Service.  

Over the year 2024, Amandeep could have easily achieved 100% across all key performance indicators, but had the misfortune of receiving 2 Action Alerts in 3 Non-World Class Surveys that were due to migration-related issues and not him as the representative.  

In addition to that, Amandeep received multiple 100% CQA Evaluation Scores while maintaining a World Class Contact score of 91% across two different departments, further demonstrating his ability to utilize Ulysses to its full potential. 

Regarding Mosaic / Migration, Amandeep has navigated the project with celebratory success.  

In addition to providing outstanding service, Amandeep was a valuable resource for discovering and reporting migration-related issues, building a close relationship with colleague Michelle Roy to help uncover technical-related issues, and ensuring they were reported with supporting documentation. 

Amandeep’s attention to detail is evident when working both with customers and colleagues and his care to ensure things operate smoothly and accurately is demonstrated by his nature to uncover account, billing, and technical-related issues.  

Having moved to the Business Support team after only 8 months of being with the company, Amandeep immediately had an impact on the department, notably by  helping tenured employees navigate Salesforce and migration changes, and providing resources and positive feedback to new hires to help ease the transition into their new role.  

Amandeep consistently goes out of his way to help both customers and his fellow colleagues. As a result, Amandeep is regularly working on different projects, both customer- and company-related. 

For the Business Support team, he is already planning out what customer visits would look like, as customers are eager to have a better understanding of their accounts, account structure, billing, and how this can be molded to their business. This idea was sparked by Amandeep turning an irate customer into one that is now very fond of him. The customer is a transportation / trucking company and was receiving bills for both their trucks and trailers. All the customer’s bills were directed to a singular address belonging to an employee of the company. Payments could not be made. The customer had more invoices than they knew what to do with and pleaded for help through live chat one day. 

Amandeep identified the customer’s frustrations and quickly provided a solution that aligned with the customer’s needs. Amandeep utilized empathy, strong communication skills, and confidence to arrange a phone meeting with the customer to address their issues. The customer was elated to have been heard and to have finally received help. 

After having spoken with the customer to gain a better grasp of their business, Amandeep identified it would be best to have multiple billing accounts for this business. Each billing account would contain the truck, trailer, and transponder associated with the vehicle. This would ensure any possible billing discrepancies would be contained to one account and the invoices could be addressed to the individual drivers. 

To achieve this, Amandeep made a custom spreadsheet that outlined all their accounts, plates, transponders, and where the bills are going. The customer sent back an edited version with the corrections to be made.  

Amandeep acted on this request, and with the increased understanding of their business, began to restore the customer’s confidence in getting their trucks on the highway, as transponders were on the way. 

The customer had never received such service, and as a result, requested Amandeep’s assistance by name, solely. The customer has come to value and appreciate Amandeep as he took the time to listen, to understand, and to care about their problems. 

The relationship continues to flourish, and Amandeep is an example of how a customer’s experience, confidence, and overall rapport can be improved with high-level care. The same irate customer from the live chat is now a very happy customer. 

World Class Customer Service is Amandeep’s standard, and we can see this in the examples of satisfied customers throughout 2024. 

Amandeep’s consideration for Agent of The Year should not be overlooked. His ability to have a positive impact on those around him while continuing to provide consistent service at the highest level should be celebrated.  

Both his skill set, and curiosity continue to grow, allowing Amandeep to expand upon his current successes while staying motivated to provide the best possible service. 

Helen Whyte – Alberta Blue Cross

I am thrilled to nominate Helen for the Agent of the Year Award in recognition of her extraordinary dedication, compassion, and commitment to providing exceptional service to our members. 

Helen is not just a customer service specialist—she is an invaluable asset to our team. Punctual, thorough, and consistently delivering first-call resolution, Helen provides an exceptional customer experience for all our members. What truly sets her apart is her incredible ability to empathize with those she serves. 

One particularly memorable instance involved a member who tragically and unexpectedly lost her husband at a young age. Amid her grief, the member received an ambulance bill, which painfully brought back memories of that heartbreaking day. Helen’s response was nothing short of compassionate. She listened attentively, providing the member with the support and guidance needed to navigate the claim process. Helen’s understanding and empathy in this emotional situation went far beyond simply resolving the issue—it helped ease the member’s burden, even if just for a moment, during a very difficult time. 

This is just one example of Helen’s ability to offer not only customer service but genuine care. She handles even the toughest and most emotionally charged situations with grace and compassion, ensuring that members feel heard, understood, and supported. 

In addition to her outstanding service, Helen has also been a true team player. Throughout this month, she has taken extra calls at the end of her shifts during peak call volumes, ensuring that our members don’t experience long wait times and helping her fellow team members finish their shifts earlier than if her additional help hadn’t been provided. Her willingness to go the extra mile for both our members and her colleagues demonstrates her exceptional dedication to the success of the entire team. 

Helen’s empathy, exceptional service, and teamwork make her a standout member of our department. She not only meets expectations but consistently exceeds them, leaving a lasting positive impact on both our members and her colleagues. She is truly deserving of this award. 

Pam Lipka – Alberta Blue Cross

The Customer Services department manages over 600,000 inquiries in a year between the hours of 6 am to 5 pm, Monday through Friday. We support benefit plans for groups, individuals, government, and French-speaking members in a variety of access channels including phones, webmail, and the Member Services Site for self-service. In Customer Services, we are committed to providing world-class service to every member interaction, and we hold ourselves accountable to strict service standards and targets. We promote member experience and support the organization by resolving health and benefit inquiries, issues, and escalations by providing accurate information and correcting the members' accounts by way of coordination of benefit adjustments, plan merges, and payments, to name a few. 

Pam Lipka is a Customer Service Specialist who has been with the department for over 3 years. Her commitment to service is unparalleled, as demonstrated by her exceptional results. Pam boasts a 100% CSR CSAT – customer satisfaction rate, coupled with a 100% resolve rate. This means that 100% of the members consider their interaction with her to be world-class. You can’t get any higher results than that! 

She received a lot of member compliments from members this year. Here are just a few that stand out: 

• “Pam was the person who received my call. She was extremely pleasant and knew exactly how to help me navigate on the other end on my computer to put in a claim. Thank you very much, Pam!” 

• “She was very knowledgeable and helpful. She provided the best customer service I’ve received in a long time from an organization.” 

• ‘She was very helpful and understood exactly what I needed.  I was placed on a brief hold while she made the fix, and she even double-checked everyone on file to ensure it was completed for everyone. This eased my mind.” 

• “The young lady who handled my car was extremely efficient and took the time to look into everything for me, making sure that it was all handled before ending our conversation.” 

• “Pam was extremely helpful – much more so than the last customer representative I called. I appreciated her assistance and clarity very much.” 

• “She was amazing. She actually cared and handled my urgent call and called me back within minutes with it resolved. She was very caring.” 

• “Pam was so helpful and patient. She explained information thoroughly and was clear and concise. I feel Pam went above and beyond.” 

• “Pam was warm, informative, and I could not have asked for better service than what Pam provided this afternoon. Pam made my day.” 

Pam is an exemplary Alberta Blue Cross employee. Her quality and productivity scores, coupled with everything that was said in feedback, cast Pam amongst the stars. Our members are always her top priority, and she ensures that she provides first call resolution for our members. 

Heather Hayes – Blue Cross and Blue Shield of Kansas

I am the mother of a terminally ill child, and like millions of Americans, I rely on my health insurance to not only provide me with coverage, but to help me obtain something more precious: time. Time spent not worrying about my own coverage is a rare commodity and is something that I try to convey to all our members. I have spoken with members on the worst day of their lives, children who have lost a parent, members as they have received a new serious diagnosis, and everything in between. 

Most recently, I worked with a member who was newly diagnosed with a rare form of cancer. She reached out to us to make sure that the lifesaving treatment that her provider planned for her as a Hail Mary was covered. She was scared, confused, worried, and angry. I let her know how her plan would assist her and assured her that no matter what, we are in this together and are here for her should she need anything. She was so grateful to have something off her plate and thanked me for my time, as if she was taking my time or was an inconvenience to me. I wanted her to know that the statement we gave wasn’t just our promise to her or something that we “have” to say; it was something that we live every day.  

Our members are our beating heart, and we are their circulatory system. We don’t just answer questions without feeling; we support them through everything, in good times and in bad. I know firsthand how important it is to protect your time with your family, with your children, and to be with them when they need you the most. Time spent not worrying about whether insurance will be there when we need it is time better spent with more important people. I try every day to embody the phrase, “We are here for you,” because we are here for our members. Without them, there would be no us, and I am blessed to have the opportunity to make even the tiniest difference in our members’ lives, even if it is just something as simple and precious as time. 

Kayla Evans – Blue Cross and Blue Shield of Kansas City

Kayla was hired in early 2022 and has exhibited excellent customer service since day one at Blue Cross and Blue Shield of Kansas City (Blue KC). Her drive for the best results ensures that she provides members with the best customer service possible. Kayla prides herself on first call resolution and the satisfaction of our members.  

Kayla has been World Class Certified every year she has been eligible. Her results in 2023 ended her year at an amazing 100% of attributable calls, which is outstanding.  In 2024, she continued to show impressive results at 96% of her attributable calls. 

Kayla has truly been a beacon of excellence this year, shining brightly through every challenge, and delivering exceptional service. Her commitment to our members has been nothing short of inspiring. Time and time again, she has risen above to create extraordinary experiences for our members. Her positive attitude and commitment to her work make Kayla a pleasure to work with. Kayla greets each member with the warmth of a smile that comes through the phone. Often members thank Kayla for the energy and positivity she brings. 

Kayla goes above and beyond, leaving lasting impressions on our members that move them deeply. One remarkable story is of a member, an EMT, who needed a knee replacement but couldn’t qualify until he lost 10% of his body weight. He was a first responder, so the ability to walk was imperative. After struggling to lose weight and succeeding, the timing of his authorization submission versus when the weight was lost led to complications in approval. This member had called in several times prior for status updates, to check into requirements and alternative treatments to assist in losing weight. 

Before being hired by Blue KC, Kayla was also a first responder, so she understood the passion, and she knew immediately that he deserved the best that Blue KC had to offer. Kayla took it upon herself to follow up with the member. He had been working through the denial of the first appeal and the submission of the second. Kayla worked with the member to ease understanding of exactly what criteria were needed to help obtain a resolution. Kayla set up a conference call with the member and our team working on the authorizations to explain exactly what was required. Kayla understood this was the member's second appeal, so she wanted to make sure he had everything possible needed to help with proceeding.  Speaking with the member, this was a critical situation: the member had already taken time off work, and, if further delays occurred, he would lose both his job and his home. 

Kayla engaged in multiple calls with both the member and his wife, who were anxious and understandably in tears with worry. Kayla said she felt that she was their last hope. She reached out to the provider and informed them of what was required, providing instructions for the appeal process. Kayla advocated for the family with a passion that only someone who genuinely cares could exhibit. She did all of this while keeping the family fully informed throughout the entire process. As a result of Kayla’s relentless dedication, the family succeeded in getting the denial overturned, and the member’s surgery was scheduled. The gratitude from the member and his wife was overwhelming; they called back several times to thank her personally. In a heartfelt voicemail, the member shared: “That is fantastic news. We also got a message from my surgeon’s office stating it had been overturned. I’m so happy to report that my surgery has officially been scheduled for the end of the month. Thank you again so much for all of your help with this. You truly made a difference.” The member had his knee replacement after Christmas. It was the best gift for them, knowing that Blue KC had their back and that we truly cared. 

Kayla consistently ranks as the top representative for Kudos calls.  Receiving an outpouring of praise, Kayla’s excellence is evident with 56 World Class surveys in 2024.  Her empathy goes beyond just numbers and is a testament to her consistency and commitment to providing exceptional results. She doesn’t simply resolve problems, she restores hope.  Kayla has fully adopted the “Blue Way” and is such a valuable asset to our team. 

Lacey Williams – Blue Cross and Blue Shield of Kansas City

Manager Details – Todd Connery

I am nominating Lacey Williams for SQM Agent of the Year consideration. Lacey consistently performs well across all BlueKC standard goals. Her service and team-oriented mindset demonstrate strong connections to BlueKC Core Values titled: Better Together and Excellence. For her 61 SQM surveys in 2024, she scored 92% World Class and 75% FCR.

Lacey is a team and company service culture influencer. She was an active participant in the Belonging Committee, which focuses on inclusion and engagement. She also took part in a committee that helped improve EOBs, which helped members better understand their claims details and reduced the number of inbound calls. 

Lacey is assigned as a benefits service contact for a group aligned with concierge services through Blue Connect. In this capacity, benefit coordinators at the group can escalate service questions or needs directly to Lacey. 

Lacey also took on two new lines of business in the past year. Her training on the pharmacy line helped with her World Class and FCR ratings as she reduced member transfers to the pharmacy team. In a team meeting, Lacey shared real examples of members having medical and pharmacy insurance questions that she was able to satisfy within one call and with no transfer. Lacey’s service story helped promote the service experience opportunities with our members as we began training more agents on pharmacy. 

Her engagement and service attitude set a powerful example for our team. She is quick to volunteer to flex her schedule or work extra hours when needed. Lacey has shown her personal engagement below in her own words, sharing specific service highlights from 2024. I enthusiastically nominate Lacey Williams for Agent of the Year consideration. 

 

Agent Details – Lacey Williams 

My name is Lacey Williams. I am a senior advocate and have worked at BlueKC for 3 years. I have proudly maintained a World Class rating for the entirety of my time assisting members of BlueKC. It brings me so much joy to help members with claims issues, locating services at lower costs, calling providers on their behalf, and advocating for them to the best of my ability. In 2024, I was fortunate to assist many members with their issues, but I’d like you to read a story that I am very proud to share. 

A member received a quote from a local hospital for an MRI with an estimated member cost of over $1,700. She was distressed about having to pay such a large amount for a procedure upfront. I advised her that the costs may be more affordable at an imaging center. Through the BlueKC Smart Shopper program, I was able to identify an imaging center for her MRI at a cost of less than $500. This resulted in a member savings of over $1,000. While reviewing her prior authorization information for this procedure, I noticed it would expire the following day. I was able to contact our prior authorization vendor, and with their help, received a date extension updated to the imaging center we identified through Secret Shopper. I forwarded the authorization to the new imaging center to let them know the member’s authorization had been updated and they would receive it shortly. The member was able to schedule the appointment within a few days, which helped set their mind at ease. The member was so thankful and gracious that she requested to speak directly with my manager to relate the service experience. 

Helping this member and all members is something I take a lot of pride in. I feel like I’m doing a significant part to make our members genuinely feel like they are cared for and that they are the best part of BlueKC. It would be a great honor to be chosen as the 2024 SQM Agent of the Year.  

Below are some wonderful comments from some of our outstanding members related to the service I had the pleasure to provide in 2024. 

• “I am more than very satisfied because she seems like a super nice person, and was very willing to help. She's outstanding. Like I said, she's as good of a customer service rep as I've ever dealt with at any company in my 54 years.” 

• “She was very thorough in listening to what I was saying about issues that I was having. I felt like she went above and beyond trying to make phone calls to track down this claim that I have received the paperwork for, which was very vague, and we couldn't really get in contact with the people we needed to. She was able to track that down and get the right people. She contacted the insurance, and they corrected on their end so that the right people would be billed. So, I felt like she went above and beyond to help me out.” 

• “She was very detailed and thorough with the information that she provided. Even with the questions that I asked, she was able to take her time and really make sure that I understood what was going on before we ended the call.” 

• “She was just very helpful. There are not a lot of people who would sit on the phone with you for 30 minutes and help you out. So, it was really helpful.” 

• “It was an exchange that was handled by someone who seemed to be working on my behalf.” 

• “Lacey was phenomenal. She had the answers that I was looking for, and she took the initiative. She immediately contacted the department that was needed because they had to reprocess a year's worth of claims.” 

Quita Weston – Blue Cross and Blue Shield of Kansas City

Manager Details – Todd Connery 

I am nominating Quita Weston for SQM Agent of the Year consideration. Quita consistently performs well across all BlueKC standard goals, particularly with inquiry timeliness of 99% which connects to FCR. Her service and team-oriented mindset demonstrate strong connections to BlueKC Core Values titled Better Together and Healthiest Life. For the 57 SQM surveys in 2024, she scored 91% World Class and 83% FCR. 

Quita’s path to this success was remarkable as 2024 was her first year receiving SQM surveys. She started 2024 strong through April with WCC scores above 90%. This dipped down in the mid-80% for June through July, but she finished 2024 strong, reaching 91%. Quita maintained her curiosity and learned from her experiences with SQM peers. She accepted feedback from her Operations Leads. 

Quita speaks up routinely in team meetings and peer chats. She is a champion for system source of truth use and SOP utilization. Her navigation of systems and support material is masterful, with very little dead air as she references information quickly in a manner that flows incredibly well as a real discussion with members. Members do not perceive that she is accessing multiple systems.  

Quita took on an additional line of business in 2024 and speaks fondly of the service she provided on this line. When other team members were frustrated, Quita spoke up about how well she enjoyed servicing the calls and quipped, “You can send all those calls to me. I really enjoy them!” 

Quita manages inquiries efficiently and helps coordinate the completion of written correspondence to members with her peers. This is an additional example of her engagement. Quita has also demonstrated her initiative-taking approach and engagement in her own words below to highlight specific service experiences from 2024. I sincerely appreciate any consideration the SQM committee will give to this nomination for Quita Weston as Agent of the Year. 

 

Agent Details – Quita Weston 

My name is Quita Weston. I started with BlueKC in June of 2021, but 2024 was my first year receiving SQM member surveys. When I began in 2021, I was excited to be back in the field that is so dear to me. I know healthcare insurance can be very confusing, and I have always taken pride in helping others gain a working knowledge and understanding of their benefits and how they can work best for them. 

Over the years, I have worked diligently to ensure that I provide accurate information to our members promptly. I have used every call as an opportunity to not just resolve an issue, but to help make someone's day better. I have been known for and complimented on my empathy, friendly tone, and patience with our members, as well as my problem-solving skills. I have built a reputation for being thorough, caring, and ensuring that our members feel heard and valued. 

I have achieved 100% ratings in Customer Satisfaction, contact resolution, and WCC-CSR Score, which help show my dedication and is a testament to my hard work, consistency, and dedication to excellence. 

I have faced challenges, though. I was so nervous when we were told about the World Class Surveys and then changing to Blue KC reps taking Group 25 Provider and Member calls that I dipped slightly to 91%. I knew that while I provided high-quality customer service, my efficiency in resolution could improve. I will continue to analyze my approach by identifying common customer issues, streamlining resolutions while still making members feel valued, and maintaining a positive attitude even during tough calls. 

My journey is not about numbers; it is about making every moment count as I help our members feel heard and valued. I strive to provide concierge service to my members and will continue to be consistent over time. With small, powerful shifts, my results will remain high, and my service to our members will remain smooth and positive. 

I strive to be thorough in assisting our members. When needed, I will call out to providers, send emails to any relevant departments, and do whatever research is needed to ensure our members get a resolution. 

I received a call from a member on August 30, 2024. She was unsure why she had received a check for a dental provider that she had been going to for some years; however, she discarded the check and wasn’t sure why she was being billed $294. I looked over several claims and realized that there were some discrepancies with the provider ID that was being used by the new dentist she had been seeing since her old dentist had left. This was a unique and delicate issue. I collaborated with my Operations Lead, and we worked together to get some documents from the member and provider. We sent emails to the BlueKC Dental team, who collaborated with us to ensure this issue was corrected and the claims were reprocessed and corrected promptly. This member was delighted and sent a Kudos Via “Contact Us” through her BlueKC Member Portal about me: “I just want to ‘Shout Out’ Quita, my Care Guide, who went the extra mile to resolve an outstanding issue with my dental provider. She not only stayed on the telephone with me to talk to the provider’s billing office but also followed up with me a week later to share the actions taken by my provider and the fact that the issue had been resolved. It was very unexpected but made my day! Excellent customer service is a priority at BlueKC, and Quita demonstrated that with me on this issue. Keep up the great work!” 

Another member called in, concerned about his claims and how they were processed. He was also concerned about paying out-of-pocket at a self-pay rate vs allowing the claim to be processed through insurance. I took the time to hear this member out and understand exactly what his concern was. I was patient, kind, and considerate of what he was going through. He spoke with my manager to pass on his appreciation. Below is an email from my manager regarding the conversation they had with the member. 

I received a call from a member who couldn’t say enough good things about your assistance. They mentioned they had a disability that led them to be confused at times. Here are some of their direct quotes:  

• “Quita was wonderful.”  

• “She's a huge asset to you guys.” 

• “Quita has a nice voice and is so gentle and kind.” 

• “She does really well, and it's frustrating sometimes for me because my brain just stops working. She's great!” 

• “I've gone through a lot, and Blue Cross has been great.” 

 

Thank you so much, Quita, for providing such care and acknowledging the member’s recall of the services you had previously provided to him. He felt connected to you from the beginning of the call. I have listened to the call, and you were truly personable and empathetic to his circumstances. I advised him that we appreciated his feedback, that he may be invited to a survey regarding your services, and that his impression is important to us. He said he appreciated having the good fortune of speaking to you on more than one occasion. What a wonderful impression you’ve made! Keep up the great work!  

 

Here are some of the SQM survey responses I have received: 

• “She was very patient, and she answered all my questions. When I didn’t know the names of the providers, she patiently waited for me to look them up.” 

• “They were very polite. She could answer my questions very quickly. I needed some information emailed to me, and she sent that to me right away too. So, just very helpful and knowledgeable.” 

• “They found exactly what I needed in a short time and emailed me exactly what I needed with more options than I figured that I was going to get. I thought I was only going to get maybe one or two. They gave me a list of five to seven options.” 

• “She provided great customer service. She was very peppy on the phone, which is always nice to hear. She answered my questions pretty fast.” 

• “She was positive, assured me that she could get me my answers, and made me feel comfortable with the questions I was asking.” 

• “She explained everything that I needed to know about my question.” 

• “She was super nice. She took the time to explain things to me, listened to me, and tried her best to figure out a solution that I needed.” 

 

Here are some of the Shout Outs I have received directly from BlueKC employees: 

Recognized for "Better Together": 

• Quita consistently helps the team and our callers by following through and resolving concerns expeditiously. She is prepared with her tools for researching and shares her knowledge in our weekly meetings. Quita's can-do attitude and resolve are part of her quiet leadership skills. Thank you, Quita, for your contributions every day! 

Recognized for "Healthiest Life": 

• A member relayed praise for the service excellence provided by Quita Weston. The member detailed that Quita conferenced with the dental provider's billing office to support the resolution of a long-standing claim issue. The member was also impressed that Quita followed up later to confirm the resolution of the issue. Quita, thank you for partnering with this member and taking action to resolve the issues.  

Recognized for "Excellence": 

• Quita Weston was very helpful in getting me set up with my member portal. She had to submit a ticket to IT. She kept track of the ticket and touched base with me to see that everything was accomplished correctly and that I understood everything after she was notified that the ticket had been closed. 

Recognized for "Excellence": 

• Quita has been over the top helpful! She has gone above and beyond to help my wife clarify our benefits and try to obtain a CPAP machine before the end of the year. After a week and a half of calls to the doctor, Care Guide, two other benefits team members, and the Vendor's medical authorization and customer service departments, Quita has obtained the information necessary to move the process along. She has been kind and personable throughout. As a team member looking to encourage others to improve, she stated that the issue and information will help with training the team and medical teams for the future.  

Recognized for "Inclusion": 

• We spoke with a member this week who gushed with praise for the service provided by Quita Weston. The member thought she was wonderful and a big asset to Spira and BlueKC. The member explained that he had a brain condition that makes understanding details a challenge. He appreciated Quita's care and patience. Quita, thank you for taking such wonderful care of this member.  

Recognized for "Better Together": 

• I appreciate you for always being prepared with resources and your reliability in completing resolutions for our members. You patiently and kindly coach team members with any challenges. Thank you! 

 

Tara Morrison – Blue Cross Blue Shield of Massachusetts 

Tara Morrison is a Diabetes Navigator with the Medicare Service Center. Diabetes Navigators receive specific ongoing training relating to this complex disease to provide resources, guidance, and support to our diabetic members. Tara surpasses the definition of a teammate and member advocate. She goes the extra mile on every single call to make sure our diabetic members are aware of all the resources we have to offer them, ensure that they are able to get their medications, and make them feel heard and appreciated. Members are often overwhelmed by a recent diagnosis, or they may be prideful, embarrassed, or scared, but Tara always takes the time to truly listen to our members. She picks up on small phrases or emotions in the member's voice and knows how to educate them and provide education and guidance in a caring, nurturing way that leaves members feeling understood and supported. Tara utilizes the range of our business’s greeting cards to send personalized cards to the members she has spoken with, encouraging them on their diabetes journey or congratulating them on reaching their goals. 

Tara has a positive attitude that is contagious! Her outlook, paired with her eagerness to share knowledge and her experience with her peers in a clear, digestible way has had a lasting impact on the team. Earlier in the year, her peers were struggling with handling calls related to certain diabetic medications, and Tara took the time to thoroughly explain the whole process to the newer Navigators, which made a tremendous difference in the service we provide to our members. Tara was selected to mentor her peers, providing them with valuable information on best practices, research skills, and being an example of what great customer service looks like. Tara’s member calls were often used to showcase the excellent work being done within the Diabetes Pod and were played for her peers, leaders, and executives within Medicare Markets. 

One of those calls I remember listening to was with a member who was newly diagnosed with diabetes. The member was timid, but Tara was able to organically turn the call into an educational discussion where they had a meaningful conversation about diet. She referred the member to our in-house dietician. Tara explained how glucometers work, the benefits he has related to diabetes, how to sign up for diabetes self-management training, and what medical nutrition therapy was. She explained that making small changes, like diet and exercise combined with medication, may help him over time. When the member asked about a specific medication and if he should be on it, Tara did a great job of referring the member to their doctor, and sharing that she had recently attended an Ask The Expert session with the American Diabetes Association where the speaker had said that most newly diagnosed patients start on metformin, and recommended he speak with his doctor about what was right for him. The member left the call feeling confident about his new diagnosis and how to move forward in learning how to care for himself. Tara followed this conversation up with a greeting card, encouraging him to reach out with any questions. 

Tara is positive, gracious, relatable, funny, and most importantly, she is humble. I’ve enjoyed working with Tara over the years, and I am so appreciative of the support she provides to peers and leaders alike. She truly enjoys the work that she does, and it shows on every call, every time. 

 

Here are some SQM Member Verbatims: 

• “She was very good. She answered all my questions. She actually offered me more advice than I was looking for or had called for, which really helped me out a lot. She was fantastic.” 

• “She speaks very well. She's extremely well informed regarding all of the details about how that business works. She communicates the terminology and the protocols in a simple way that I, who is not familiar with them, can understand. She was completely professional, had an excellent sense of humor, and listened expertly. She understood immediately what I was looking for and provided it, clearly and simply.” 

• “She answered all our questions very professionally, and she's been very friendly. When we got off the phone, we were extremely happy that we're with Blue Cross and Blue Shield.” 

Dana Flowers – Blue Cross Blue Shield North Carolina

Dana’s calls are a dream to listen to. She treats every member she speaks to with the same level of care and truly goes above and beyond on every call. This is evident by her high SQM scores. For 2024, Dana ended the year with 78% FCR, 92% Issue Resolution, and 96% customer satisfaction. One member said of Dana: “Dana was excellent. She knew exactly how to help me, and I am so thankful for her. I wish I could speak to her every time I needed to call. Thank you for having such a wonderful employee.” She is the model for what every CSR should strive to be. 

Dana is very active in our team meetings and daily in our team chat. She is always one of the first to offer to do side-by-sides with our new CSRs or even with some tenured employees if there have been any changes that they are struggling with. Dana often provides encouraging words to her peers and will lend a helping hand any time it is needed. 

Going the extra mile is Dana’s nature. Dana spoke to a member at the end of the year who was planning for his 2025 annual exam. He wanted to confirm his benefits for the next year because he was billed a significant amount for his last exam. Dana took the time to review his prior claims and noticed there may have been an error with the way his claims were filed by the provider. After advising him of his benefits, she let him know that she thought there was an issue with his past claim and wanted to reach out to his provider to ask if they would review. He was not optimistic but agreed. Dana got the provider on the line, and they identified their error and said they would refund the member. The member was extremely grateful for the help and was taken aback by her taking the time to do something he did not even think to ask about. Dana followed up until the member got his refund for the money he paid. 

Dana’s approach to speaking with our members is to establish trust and rapport by actively listening to them and then paraphrasing their concerns to reassure them that their issue is valid. She does an amazing job of reassuring them that they have the right person to help them get to the bottom of their issue and provide resolution. She communicates clearly in plain language without using any jargon about what steps she will take to resolve their issue so that they feel informed and respected. She uses positive affirmations during her conversations like, “Thank you for sharing your concerns with me,” “I’m here to help,” and “I appreciate your patience.” These steps have helped Dana to turn upset members into satisfied members, even when the outcome is not what they wanted. 

Dana refers many of our members to our case management nurses. She listens very intently to each member she speaks to and can identify when a member may need some additional assistance beyond customer service. This helps members possibly save on prescription drug costs and maybe even find a specific type of provider for their issue. Dana spoke to a member who was calling in for her prescription benefits. The member mentioned that she did not particularly like the medication that she was on because it did not make her feel the best. Even though there is nothing Dana could do to change the member’s prescription, she advised the member that we have internal nurses who can discuss that with her and maybe even help to alleviate her dissatisfaction with her medication. Dana transferred the member to case management. The member later called in wanting to speak to Dana again because she was so nice to her before, and she wanted to tell her that she got her medication changed with the help of the nurse. If Dana had not noticed that, the member would not have known she had any other options to assist her. 

Dana leads the team with the most World Class calls almost every single month and averages over 90% in customer satisfaction monthly as well. She truly has a gift for making members feel they are being well taken care of. 

Nekia Tubbs – Blue Cross Blue Shield North Carolina

Nekia Tubbs' journey as a Customer Service Representative (CSR) is a shining example of dedication, empathy, and excellence. Her story is one of unwavering commitment to customer satisfaction and a relentless pursuit of excellence, making her a standout nominee for CSR of the Year. In the fast-paced world of customer service, where every interaction can make or break a customer's experience, Nekia Tubbs consistently rises to the occasion. Her journey is a testament to the power of empathy, dedication, and a proactive approach to problem-solving. 

Nekia's commitment to member satisfaction is unparalleled. She goes above and beyond to ensure that issues are resolved on the first call, often collaborating with other departments to guarantee a complete resolution. Her proactive approach to anticipating member needs and dedication to excellence make her a dependable team member who can always be relied upon. Nekia's willingness to share best practices with her peers fosters a culture of continuous improvement and collaboration, setting a high standard for the entire team. 

Her approach to each call is a testament to her commitment to providing world-class service. Nekia quickly builds connections with members through her empathetic tone, asks the right probing questions to understand the issue fully, and works diligently to provide solutions with options. Her ability to anticipate member needs and follow through with commitments ensures that members feel heard and valued.  

Nekia's influence extends beyond her interactions with customers. She consistently leads by example, demonstrating exceptional customer service in every interaction. Her support and guidance to her peers are invaluable, and her recent promotion to the role of Personalized Service is a testament to her ability to help members through challenging situations. Even in her new role, Nekia continues to provide support and guidance to her peers through Microsoft Teams Chat, recognizing and celebrating their achievements, and fostering a positive, motivating work environment. 

A kudos call from 2024 highlights Nekia's exceptional service. A member praised Nekia for her detective-like skills in resolving a complex issue with Cobra, expressing gratitude for her dedication and effectiveness. The member's heartfelt appreciation underscores the significant impact Nekia has on those she assists. 

What makes Nekia special is her ability to excel in her core role while also contributing to the needs of others. She exceeded all performance metrics for the year and led the team, earning a promotion to Personalized Service. Nekia oversees the most sensitive cases and is a trusted advocate for members during the most challenging times of their lives. Despite her new role, she continues to assist with taking phone calls during periods of high call volume, helping the organization meet its performance targets. 

Nekia has a natural ability to create memorable experiences for members. She builds connections through relating to their personal life experiences and understanding their needs. Her willingness to be vulnerable and show genuine empathy and compassion makes a fundamental difference in the lives of those she supports. 

Nekia Tubbs' story is one of resilience, dedication, and an unwavering commitment to excellence. Her ability to turn challenges into opportunities, inspire those around her, and consistently deliver exceptional customer service makes her a shining example of what it means to be a CSR. 

Brittany Morris – BlueCross BlueShield of South Carolina

Brittany Morris is a Customer Service Advocate III on the State Operations Member Service team, and it is no surprise that she is World Class Certified for 2024. Brittany has been a huge asset to the department in many roles through the years. Brittany has had over 200 World Class surveys for 2024. No matter the situation, Brittany is always willing to go above and beyond for all our members, and she does it with a smile. We can always count on Brittany to be the first representative on the phones in the mornings before the call center opens. She always volunteers to stay over to assist with calls if the volume is high because she is dedicated to making sure we meet our ASA standard and that each of our members is taken care of.  

In December, Brittany received a call from an upset member. The member knew she needed services, but was concerned with the out-of-pocket responsibility. Initially, the member was upset because, as we all know, prescriptions and doctor office visits can be expensive. The member advised Brittany of the services she would need and provided the prescriptions she would need. Brittany went code by code with the member and thoroughly explained each. She was able to give the member the amount for each service. Throughout the call, the member’s voice went from being worried to being calm. The member’s questions continued because she wanted to make sure she was able to afford the visit and her prescription. 

While on the call, the member asked Brittany, “Do you mind spending some more time with me?” Brittany quickly responded, “Absolutely!” After listening to this call, my heart smiled because I knew that this member had what she needed, and she was relieved. In addition, the feedback left by the member was phenomenal and confirmed why Brittany truly is World Class! She advised, “Brittany was very professional, and she knew her medical codes. She was glad to spend time with me on the phone trying to resolve how much my out-of-pocket expenses would be for some unusual psychiatric treatment. She offered an alternative code for a pharmaceutical drug that my doctor would be using. She told me why a different code might be better, and that's it. She went above and beyond, which is very helpful to me to find out how much money I would be spending at my next appointment.” 

Brittany has always been thorough when assisting our members. She is helpful and focuses on taking steps to ensure low customer effort. In State Operations, we believe that “Nobody cares how much you know, until they know how much you care.” Brittany exemplifies this daily through her work on the State Operations team. 

 

Carlene Curtis – BlueCross BlueShield of South Carolina

Carlene consistently delivers a world-class experience to members. Numerous members have praised her compassion, patience, and dedication. The stories below highlight her consistent approach to treating each member with care and her exceptional call-handling skills. As a peer leader, she also helps others reach their full potential. 

One day, a member called in distress about her father’s procedure, which had been denied twice despite their appeals. She shared how Carlene went above and beyond to get her father pre-approved for surgery. Out of everyone she had spoken to, Carlene stood out as the best. The member wanted to give Carlene recognition for her incredible help, expressing that she wasn’t sure her father would have been approved for surgery without Carlene’s unwavering dedication and support. Carlene’s compassion and determination made a world of difference for the member and her father. 

One member was quite concerned about an overcharged bill and had the privilege of speaking with Carlene. She expressed that she had never experienced such tremendous customer service before! While her other insurance had dropped the ball, Carlene stepped in and made all the necessary calls on her behalf, ensuring everything was taken care of. The member was amazed at how Carlene resolved all her issues in just one phone call. Carlene’s dedication and exceptional service left a lasting impression, turning a stressful situation into a positive experience. 

Another member specifically wanted to commend Carlene for her exceptional assistance in explaining charges and resolving issues. The member had been previously assured that her charges would be covered, but was later billed and had to pay some of the charges. Carlene thoroughly explained the situation, the resolution process, and what steps she could take to help. She was pleasant and very knowledgeable throughout the interaction. When Carlene needed to put the member on hold, she apologized, asked for permission, and clearly explained what she was doing. The member noted that she could hear Carlene’s genuine willingness to help in her voice. It wasn’t just that Carlene helped save her money; it was also the considerate and thorough manner in which she did it. Carlene is a wonderful representative for BCBS, and the member was very appreciative. 

Chanarrah Diamond – BlueCross BlueShield of South Carolina

Every great team has a shining star—someone who doesn’t just do their job but elevates the people and experiences around them. For our customer service team, that person is Chanarrah Diamond. Since joining as a Customer Service Representative in 2023, Chanarrah has redefined what it means to serve with excellence, integrity, and resilience. 

From her very first day, it was clear that Chanarrah was not just here to answer calls—she was here to make a difference. Whether guiding a confused caller through a complex issue or stepping in to support a struggling colleague, she approaches every situation with unwavering positivity and a genuine desire to help. Challenges don’t faze her; instead, they fuel her. She doesn’t just meet expectations—she surpasses them with a smile that can be felt through the phone. 

One of the qualities that sets Chanarrah apart is her ability to turn even the toughest interactions into positive experiences. She understands that when customers call, they may be frustrated, confused, or in need of urgent assistance. But in Chanarrah, they find more than just an agent—they find an advocate, a problem-solver, and someone who truly cares. 

A member may call in feeling overwhelmed, but by the time they hang up, they feel heard, understood, and reassured. Chanarrah’s patience, empathy, and deep knowledge allow her to navigate even the most complex situations with ease. She doesn’t just provide answers—she provides peace of mind. 

One of the most remarkable aspects of Chanarrah’s journey is her impact beyond her own performance. While she consistently delivers exceptional customer service, she has also taken on the role of team coordinator, mentoring and uplifting those around her. Of the five representatives who earned the prestigious World Class Customer Reps designation for our department, four of them were trained and coached by Chanarrah, not to mention that own her ranking was 94% above all. 

She doesn’t just teach skills; she inspires confidence. A struggling agent might come to her feeling overwhelmed, but after a coaching session with Chanarrah, they leave empowered and ready to succeed. She has a way of making people believe in themselves, of turning obstacles into opportunities—not just for herself but for everyone on her team. 

Her dedication to her peers goes beyond coaching—it’s about creating an inclusive, supportive environment where everyone feels valued and capable. She celebrates her colleagues’ successes as if they were her own and is always the first to lend a helping hand when someone needs it. 

Customer service can be unpredictable, especially in Medicare Advantage—some days are smooth, others bring waves of challenges. But through it all, Chanarrah remains unshaken. When faced with a tough situation, she not only finds solutions but does so with grace and joy, making the experience better for everyone involved. 

Her leadership team has witnessed this time and time again: 

• Carmaye Reyes, Supervisor, admires her effervescent attitude and ability to rise to any occasion, making both callers and colleagues feel valued. 

• Alicia Brown, Manager, praises her ability to foster a culture of support and collaboration, ensuring that no one is left behind. 

• Earl Brown, Manager, sees her as a true role model, someone who navigates challenges with competence and positivity while lifting others up along the way. 

Chanarrah’s resilience is contagious—it spreads throughout the team, uplifting everyone who works alongside her. No matter the circumstance, she approaches it with a mindset that says, ‘We’ve got this,’ and because of her, we do. 

What makes Chanarrah truly special is who she is at her core. Beyond her skills, her work ethic, and her ability to lead, she is simply an amazing human being. She is the person who brightens the room, who finds joy in service, and who inspires others to do their best just by being herself. 

Her positive energy is unmatched, her passion for helping others unwavering, and her ability to connect with people remarkable. She has turned everyday moments into extraordinary interactions and helped shape a workplace culture that is defined by excellence and teamwork. 

For all these reasons and more, it is with great honor that we nominate Chanarrah Diamond for 2024 Agent of the Year. She doesn’t just represent what an agent should be—she represents what we all aspire to be. 

Cheyenne Womack – BlueCross BlueShield of South Carolina

Cheyenne Womack is an ideal candidate for the World Class Agent of the Year and Agent Top CX Improvement recognitions. Cheyenne’s compassionate and empathetic nature consistently shines through on every call and allows her to connect with customers in a way that engenders trust and leaves each caller feeling confident that she can and will resolve their issue. She has a natural gift for understanding the customer’s needs and ensuring that they are completely satisfied before she considers their issue as resolved. Her calm and understanding attitude, coupled with her professionalism and knowledge, has contributed to nearly every one of Cheyenne’s customer surveys being rated as World Class. An example of Cheyenne’s professionalism and commitment to providing callers with exceptional customer service can be seen in the customer’s comments below: 

• “She was informative. She answered all my questions. She even enlightened me on so many different things. She is such an asset to you because she is very savvy, and her job skills are a cut above.  She's very knowledgeable, very personable, and was able to relate to every question that I was asking about. She was able to put it in layman's terms, and I just felt really good at the end of the phone call, and that my issues were resolved. Not only that, I felt like I had gained more knowledge.” 

Cheyenne began working with BlueCross BlueShield of South Carolina on October 10, 2022, as a CSA II in Customer Service. By October of 2023, Cheyenne’s commitment to assisting our members earned her a promotion to CSA III, and by December of the same year, her customer service skills and unwavering dedication to resolving customer issues resulted in a promotion to team work leader.  

During her employment with BlueCross, Cheyenne has offered her assistance and support to other CSAs by providing instruction and training, and has helped to create and implement a program – the SQM Increase Plan (SIP) – to assist her team members in achieving WCC status for the year of 2024. This was overwhelmingly successful as six out of eight CSAs on her team have achieved WCC status for the 2024 year.  

Further comments from Cheyenne’s members (taken from her mySQM surveys): 

• “I think you guys can see she was on it. She was really great. She answered all my questions. She was very patient. She was very knowledgeable and then she followed up with exactly what we spoke about today. She was great. It was very easy, very painless.” 

• “She was excellent. She took the time to do the appropriate research, and she took the time to answer all my questions fully to make sure that I understood by the end of the call.” 

• “She was very professional. She listened to me. She checked out to see what BlueCross BlueShield offered. When she got all that done, she said, “Would you like me to call the clinic and explain this to them?” She did so while I waited on hold, and she got it resolved.” 

• “She was terrific. She patiently helped look into how to resolve it, kept me on the phone while she figured it out, and then helped me get the information over to you guys.” 

• “She won't give up. She was on hold forever with the ambulance company. She was very determined to get me an answer. I was very satisfied because she understood my request, and she was able to get me the answers promptly.” 

Because of Cheyenne’s AMAZING work in attaining an 88% World Class certification for 2024, and her inspiring 19.4% improvement from 2023 to 2024, we are nominating Cheyenne Womack for World Class Agent of the Year and Agent Top CX Improvement. 

Eudeeta Washington – BlueCross BlueShield of South Carolina 

Eudeeta Washington started as a full-time employee with BlueCross BlueShield of South Carolina in March of 2022. She started out as a shy individual with minimal computer skills. She acknowledged her challenges and wanted to be great at what she did; therefore, she requested additional training for claims and customer service. After training, she felt very confident that she would be able to assist all her members and leave them very satisfied on every call. Her determination to help others throughout the year won her a spot for World Class Most Improvement Award in 2023. Eudeeta is always willing to go above and beyond for our members. She shows great empathy for our members’ concerns and issues. She is very personable and a great listener as she seeks to understand the members’ concerns first and foremost and then follows through on every commitment.  

Here are a couple of mySQM survey comments for the year 2023 that earned her the Most Improved award:  

• “The advocate was extremely knowledgeable. She was very polite, precise with the information she was giving me, and she never kept me on hold for an extended period.” 

• “The customer service representative listened to my issues. I explained everything for the second time, not BlueCross BlueShield's fault by any means, but she handled it. She three-way called and spoke to them. She got it resolved. Now we're just waiting for the other part to do their part.” 

From there, she set a goal to become World Class. Eudetta was asked what encouraged her to become World Class after receiving Most Improved, and here is what she had to say: “I decided that because of the person that I am – a lady with a heart of gold – I can and will qualify for World Class in 2024. Helping others is a passion that I have always had. I am determined to give all my heart to others to help them turn their day into a very satisfied day!” 

All Eudeeta’s hard work paid off with a promotion to CSA III in November of 2023. Going into 2024, she continued to show great commitment and devotion to every member that she spoke with. Everything that she expressed about who she is as a person and her passion to help others showed up through her certification ranking at #1 with 97% WCC! She also achieved WCI with a 19% improvement.  

Here are a few comments from mySQM 2024:  

• “She was knowledgeable, and she helped me resolve the issue.” 

• “She was very professional. She called the medical company that I was having an insurance problem with. Everything was handled on the phone, and she was professional and polite.” 

• “She was extremely friendly, articulate, and caring. I really enjoyed my visit with her. She was very helpful.” 

• “The customer advocate was very knowledgeable, friendly, and professional. The matter was handled in one phone call in a timely manner.” 

Here are a few KUDOS from members:  

• Member called in with concerns about trying to get a replacement wheelchair after his car was totaled in an accident. Not only was he experiencing obstacles with the process of getting the replacement, but he had additional health issues. Needless to say, he was frustrated and stressed. Eudeeta displayed deep empathy and sprang into action to help resolve his concerns and issues. I had the pleasure of speaking with him. He could not express enough gratitude for Eudeeta's patience, understanding, determination, and pleasantness. He said she is a "Gold Star" employee who deserves recognition! 

• Member called in, confused over her billing with a provider. She wanted to commend Eudeeta for being patient, professional, calm, and remaining positive even when dealing with the aggressive provider. She said Eudeeta was amazing! I am proud of Eudeeta for providing the member with a positive customer experience. She advocated on the member's behalf, explained it to the member's understanding, and was a bright shining light in the process. 

Coaching feedback regarding Eudeeta’s performance:  

• “Eudeeta was always the first to help in the coaching chat with any research questions that her teammates were struggling with. She was very good with using her resources! She was always receptive to coaching and would implement any feedback given immediately on her next call. I didn't get to coach her long because before I knew it, within her first 7 months, she was hitting World Class performance in SQM monthly! “ 

In recognition of her achievements for 2024, we are nominating Eudeeta Washington for World Class Top Agent of the Year! 

Jennifer Cassady – BlueCross BlueShield of South Carolina

Jennifer Cassady is an outstanding member of our team and embodies what it means to be a World Class Advocate. Management frequently receives praise from members about the exceptional level of service Jennifer consistently provides. A common theme among these accolades is how Jennifer genuinely cares about the welfare of our members. She continually demonstrates a strong commitment to service. 

I want to share a story about a very grateful member and the outstanding support she received from Jennifer. This member was a repeat caller who had been frustrated because she felt that no one was listening to her or explaining the problem clearly. During her latest call, she spoke with Jennifer and immediately requested to speak with a manager. From the start, Jennifer took ownership and assured the member that she would do everything possible to assist her in finding a resolution. The member was hesitant and unsure if Jennifer could truly help. It would have been easy for Jennifer to dismiss the call, but as a woman with a heart for service and a true advocate for our members, she empathized with the member. She chose to thoroughly investigate the issue from beginning to end and do all she could to assist the member. 

Despite the complexity of the situation, Jennifer kept her promise by calling the member back at the scheduled time. She clearly explained what had happened and outlined the steps necessary to resolve the issue moving forward. The member was deeply touched and was in tears, expressing her immense gratitude for the level of service Jennifer provided. She said she initially wanted to speak to a manager to complain and vent, but Jennifer dispelled that by showing kindness and patience. She wanted to make sure that Jennifer’s management knew that Jennifer was wonderful. She said, “The world, specifically insurance companies, needs more people like Jennifer who truly care for their members and will go above and beyond with every call.” 

Jennifer not only provides exceptional customer service to our members but also serves as a mentor to her peers. She is always willing to help whenever she can, and the team knows they can rely on her. Over the past year, member services have faced numerous challenges, with the most significant being inadequate staffing and the difficulty of retaining staff. Jennifer has played a crucial role in training our new employees on the phones. As part of the training curriculum, all trainees must complete several call shadowing sessions with Jennifer before they are authorized to take calls independently. This allows them to listen to actual calls and navigate the system, allowing them to ask questions if they need clarification. Her teammates have said: 

• “Jenn is the best. It doesn’t matter what she is doing; she will stop and make sure I understand the answer.” 

• “You can definitely tell that Jennifer truly cares about the member and will advocate on their behalf.” 

• “Anytime we ask her a question, she will show us where to find the answer, not just give us the answer, and that makes a huge difference.” 

Additionally, Jennifer supports our coaching and training teams alongside her other responsibilities. 

In conclusion, no one deserves this award more than Jennifer. She has a heart of gold and a genuine passion for service. Always ready to support her teammates, she embodies the definition of a World Class Advocate. 

Theresa Goodwin – BlueCross BlueShield of South Carolina

Theresa Goodwin exemplifies what a World Class Advocate should be and truly deserves the Advocate of the Year award. She consistently goes above and beyond for our members, providing the exceptional service that BlueChoice is known for. Theresa makes every effort during each call to ensure that members have their issues resolved on the first contact. As one of the veterans on our team with over 20 years of experience, she demonstrates her commitment in every interaction. If there is something she does not understand, she asks questions to ensure the member receives exactly what they need. Every member she speaks with is treated with the same level of respect, empathy, and urgency, regardless of the nature of their call. Theresa advocates for each member and treats them like family. 

The following are two examples of Theresa’s commitment to helping people when they need it most. This is an email I received giving “Kudos” for the amazing job she did with an issue a member was having: 

• “I want to thank Theresa Goodwin for being an exceptional Customer Service Representative. I was struggling to get prior authorization for an infusion my son has been receiving every month for the past couple of years. I contacted Blue Choice Customer Service and was transferred to Theresa. She was polite, confident, and professional on the phone. There was no immediate answer to my case. Theresa was willing to research the problem and return multiple calls to me. Not only did Theresa speak with me but Theresa contacted the medical provider to help bring clarity to the situation despite an Office Manager who said to me that she could not spend any more time on my son. Theresa did not give up on me, and she pursued the problem until a possible solution was found. At the end of the day, and I would assume many hours of Theresa's time, we had an urgent authorization request pending and a possibility to receive the necessary monthly medical care my son requires. The following morning, my son did receive his infusion with authorization approved. I cannot thank Theresa enough for her gifted communication skills, determination, and willingness to pursue my family's situation. The hard work she put into helping my son and me brought me to tears. When your child is sick, all you want to do is make them feel better. The last thing I wanted was for my son to suffer because he could not get the medication he desperately needed. I am so grateful Theresa picked up the phone that day. If all Customer Service Representatives would be as professional as Theresa, life would be a better place.” 

Another example is from a member who was battling Breast Cancer, and the provider’s office submitted the wrong code, which caused the authorization to be denied. The member praised Theresa’s knowledge, professionalism, and patience in getting the issue resolved. The member stated: 

• “I cannot thank you enough for having someone as caring as Theresa on your team. If it weren’t for her, I don’t know what I would have done. She treated me like a mom, a sister, and even a best friend. She was able to get the issue resolved, and I am so thankful that she answered the phone when I called.”  

These are just a few of the examples of the type of feedback we receive from our members on the service Theresa provides. Please see below for more comments from Theresa’s members taken from her SQM surveys: 

• “She was helpful and looked at the claim and then said she would follow up on it and call me back. So, she did her job, and she was very pleasant.” 

• “My advocate was Theresa, and she was absolutely wonderful. She answered all of my questions, helped me solve my problems, and followed up with me this morning like she said she would. I could not have asked for better service from her.” 

• “The representative I was working with, her name is Theresa. She was more than helpful. She even gave me a couple of callbacks to try and resolve my issue. She was able to give me peace of mind, and I really appreciate her going above and beyond for me. It means a lot.” 

• “They followed up with me very thoroughly, and I really appreciate them calling me and going over it.” 

• “She was knowledgeable. She was professional. She was very nice. She worked very hard to help me.” 

• “She was super nice. She resolved it super quickly. That's pretty much it. She was really nice, and she helped me out. She's very helpful.” 

In closing, Theresa Goodwin is a valued resource for the BlueChoice team. She consistently provides World Class Service to our members and is a World Class Advocate every day in my book. 

Michelle Leduc – Blue Cross and Blue Shield of Vermont

One evening, I received a call from a member who expressed concern regarding a claim that was not on file for services that were rendered 3 months earlier. He stated it was never submitted to insurance because the provider believed it would not be eligible for benefits. I researched the member’s benefits and discovered that not only did he have benefits for the services, but he also had an approved authorization on file. I assured him that we could speak to the provider and ask them to submit the claim for processing. I attempted to call the provider with the member on the back line but ended up having to leave a voicemail for the billing department. I could tell that the member was feeling anxious about the situation, so I assured him that I would actively work to get this claim on file and would follow up with an update the next day. Feeling the anxiety from the member fueled my desire to resolve this case as quickly and efficiently as possible. 

The next day, I called the provider’s local plan to see if they could reach out to their provider on the member’s behalf to help clear up any confusion regarding the claim submission process and to get the claim on file as soon as possible. The local plan also had to leave a voicemail for the provider, but the representative advised that they would attempt outreach again the next day. I called the member to provide an update on the case and to let him know I was working diligently on his behalf to resolve this matter. I could tell he was appreciative of the work I was doing, but he expressed that it was a stressful situation for him. I felt for him and wanted to ensure a positive outcome for this member. I would not give up until the issue was resolved. 

Two days later, I called the local plan back to ask for a status update. The plan-to-plan representative made an outreach to the provider and was able to speak to a biller directly. As luck would have it, the biller was aware of the member’s situation and agreed to send the claim in for processing. I made sure to always keep the member in the loop to alleviate any further stress, so I called him back and advised him of the good news! He was very appreciative. To ensure that his issue was truly resolved, I explained that I would monitor his account for the claim submission and call him back once it had been processed. 

For the next few weeks, I monitored for the claim to be submitted. Once it was received, I was able to call the member back and advise him of the claim status and explain how the claim was processed towards his benefits. He was extremely happy and appreciative of all the outreach and effort that I provided to resolve the issue. He expressed that I was so helpful in alleviating some strain during a very stressful time in his life. He shared that my consistent updates helped him to feel well-informed and cared for. It was my absolute pleasure to assist one of our members by ensuring this claim was able to be processed toward his benefits. As I reflect on this case, I can still feel the anxiety the member felt on his initial call, and although this situation took some time and diligence to resolve, it was well worth it in order to provide him with the positive resolution he deserved. 

I strive to give exemplary world-class service to all members and take them out of the middle whenever possible. Our CS Team strives to deliver world-class service on every call. I love working for Blue Cross Blue Shield of Vermont, and every time I assist a member and obtain a positive outcome, I feel energized and want to continue to provide the best service possible. We are a small but mighty Blue’s Plan! 

Terry Lyn Bicknell – Blue Cross and Blue Shield of Vermont

Sometimes, navigating the world of insurance, next steps, and options is difficult for those who don’t speak our language. Every time I take a call, I begin by putting myself in my member’s shoes. With active listening, good probing questions, and validating my resources, I develop a sense of trust and rapport with my caller. In this situation, I collaborated with my peers and developed the best next steps, as the answers were not cut and dry. 

I spoke with a member's wife in August 2024. Her husband had sustained an injury two months before and was still seeking services to recover from falling down a flight of fourteen stairs. He sustained a traumatic head injury and fractured his C-7 vertebrae. The injury had not only caused a ten-day gap in memory, but had also caused a subarachnoid bleed on the right side with intraventricular bleeding as well. He experienced balance issues and difficulty walking. The injury caused left side weakness and leaning, which caused his foot to drag. He experienced facial numbness on the left side, severe tinnitus, vision issues, and short-term memory loss. 

This injury required intensive treatment as he had been rendered unconscious from the fall and had stopped breathing. He spent five days in intensive care, transferred for five additional days to the neurological floor, then transferred to Boston for intensive therapies to improve his overall functional status so he could return home to Vermont. 

In this member's experience, time doesn’t heal all wounds, and not all doctors are created equal. Months after the accident, the member was left with debilitating symptoms of numbness, tingling, and abnormal sensations of the face, eyes, mouth, hands, shoulders, and right foot. Also, he continued experiencing severe tinnitus, moderate to severe hearing loss in the left ear, along with dizziness, and issues with balance and fatigue. After 15 months of intensive treatments with neurologists, neuropsychiatric providers, otolaryngologists, psychiatrists, and orthopedic providers in both New Hampshire and Massachusetts, the doctors had no answers on why he continued to experience these life-altering symptoms. 

Upon returning home, it was suspected that the cervical fractures and soft tissue injuries sustained in the fall may be the root cause of the lingering symptoms. They recommended seeking services with a functional neurologist chiropractor who specialized in traumatic brain injuries. So in May 2024, the member's wife began searching for in-network providers with specific experience in the area of post-concussion syndrome. They sought services with two different in-network Board Certified Chiropractic Neurologists, they attempted different exercises and manipulations and attempted a very extreme diet regimen. After several weeks and visits, the symptoms worsened. 

As a last attempt, they were referred to a provider who had success treating traumatic brain injuries; however, they were out-of-network. There were numerous positive testimonials on the clinic website. In hopes of helping her husband, she scheduled a free consultation at the end of July 2024. 

When the member contacted me, I had several hurdles to tackle. The first issue was that the member had no out-of-network coverage. The second issue was the diagnosis was not covered. In addition to these hurdles, services were already rendered and considered post-service without appropriate exception approval. I needed clarification on what services needed an out-of-network authorization as an exception, and what services needed to be appealed. The member’s policy required in their contract that they utilize in-network chiropractors only, or there would be no benefit. In addition to this question, the out-of-network chiropractor ordered a home lab test kit, which the member paid for out-of-pocket to the provider. We were unsure what CPT codes were needed to process this as a claim, if authorization was needed, and who would be billed for this charge. Also, the out-of-network chiropractor ordered a genetic test, which needed prior approval with medical review. Finally, they needed approval for out-of-network services for visits going forward. 

Upon further investigation, peer collaboration, and referral for case management, I put together a plan of action. I assisted the member with the submission of multiple out-of-network authorizations and appeals. They needed both pre- and post-service appeals, approval for genetic testing, and the diagnostic lab. The out-of-network prior authorization review was denied as not medically necessary, so we pursued an appeal and it was finally overturned. 

Throughout 6 months of monitoring, I created numerous cases, submitted them, and provided weekly follow-up updates with the member. In February 2025, the continued efforts and monitoring finally paid off. My member got approval for the services needed, claims were adjusted, and several thousands of dollars were reimbursed to the member, at last. 

When I spoke with the wife, she was overcome with tears of joy and disbelief that someone had stuck by their side and saw them through. The treatments were finally showing improvement, and the financial burden was finally behind them. Our team's efforts gave our members hope, a light at the end of a very dark road. We saw them through and found resolution at last. 

Janel Martinez – Regence Blue Cross Blue Shield Plans

I am thrilled to nominate Janel Martinez for the Customer Service Representative of the Year award. Janel has consistently demonstrated an exceptional level of customer service, and I am honored to recognize her outstanding contributions. 

Janel's approach to customer service is truly unique and sets her apart from her peers. She has an uncanny ability to connect with each caller, empathize with their concerns, and provide personalized solutions that meet their needs. Her patience, understanding, and willingness to listen are just a few of the qualities that make her an exceptional customer service representative. 

• Empathy and understanding: Janel has a remarkable ability to put herself in the customer's shoes and understand their perspective. She takes the time to listen to their concerns, ask questions, and provide personalized solutions that meet their needs. 

• Positive resolution: Janel is relentless in her pursuit of a positive resolution for each customer. She will not give up until the customer's issue is resolved, and she will go above and beyond to ensure that the customer is satisfied. 

• Communication skills: Janel's communication skills are exceptional. She is clear, concise, and articulate, and she has a way of explaining complex issues in a way that is easy for customers to understand. 

Janel joined our company in 2024 as a new hire and immediately came out of training with a drive and desire to achieve excellent member experiences. Despite being new to the company, Janel quickly demonstrated a deep understanding of our products and services, and she was eager to apply her knowledge to help our members. Her enthusiasm and dedication to providing exceptional service have been evident from the start, and she has consistently exceeded expectations in her role. 

Janel recently helped a member who was facing a high-dollar claim denial due to a provider's failure to sign an attestation form. Janel took it upon herself to contact the provider and persistently followed up to ensure that the form was signed and the claim was reprocessed. Her diligence and persistence paid off, and the member was able to avoid receiving collection notices for a situation that was not their fault. The member was extremely grateful for Janel's efforts and praised her for her exceptional service. 

Janel also helped a customer who was struggling with mental health issues. The customer was feeling overwhelmed and was in crisis. Janel went above and beyond to get the caller connected to resources, helped set up appointments with a mental health professional, and provided information about the suicide hotline to ensure the caller had 24/7 resources in their crisis. Janel's compassion, empathy, and willingness to help in a time of need were truly exceptional. 

Janel's exceptional performance has led to her being cross-trained into many lines of business for members, including Commercial, Provider, and Health Care Authority. She has also been selected to participate in outbound call campaigns, where she has consistently demonstrated her ability to effectively communicate with members and provide personalized solutions to meet their needs. Her versatility and willingness to learn have made her a valuable asset to our team. 

Words from our members: 

• "She was very personable and very knowledgeable. She went above and beyond to make sure that my question was answered. I liked talking to her. She was very sweet." 

• "She was very pleasant and professional and answered my questions. Went above and beyond." 

• "Very professional, very knowledgeable, and extremely friendly. She checked many things out for me. She's fabulous, and I hope I get her again if I need to call in." 

• "She answered my questions effectively. She was understanding. She listened even though I was probably telling her more than she wanted or needed to know. She looked everything up. She was quick." 

• "Big kudos to the person who assisted me. I felt that she really cared about the issue I was calling about and took the time to make sure it was resolved. She looked into the issue and took additional action to handle it for me. You don't often get this type of service these days, and I was very pleased." 

Janel deserves this award because she consistently demonstrates an exceptional level of customer service. She is a true asset to our team, and her dedication to providing outstanding service to our customers is inspiring. Her ability to empathize with customers, provide personalized solutions, and resolve issues in a positive and professional manner makes her a standout in the customer service field. 

I am honored to nominate Janel Martinez for the Customer Service Representative of the Year award. Her exceptional service, empathy, and dedication to our customers make her a true asset to our team. I am confident that she will continue to provide outstanding service to our customers and inspire her colleagues to do the same. 

Jenny Weigel – Regence Blue Cross Blue Shield Plans

I am thrilled to nominate Jenny Weigel for the SQM World Class Customer Service Representative of 2024 award. Jenny has consistently demonstrated exceptional customer service skills, a strong work ethic, and a commitment to excellence in her role as a Customer Service Professional. 

Since joining our company in November 2020, Jenny has consistently exceeded expectations and has been a valuable asset to our team. Her dedication to providing world-class service to our members is evident in her outstanding SQM scores, which have consistently improved over the past year. In 2024, Jenny set a goal to exceed her previous year's percentage in SQM totals, and she successfully achieved this goal, improving her score by 10.29% and ending the year with an impressive 88.24% of SQM totals. 

Jenny's exceptional customer service skills are not limited to her interactions with members. She is also an invaluable resource to her teammates, providing guidance, support, and suggestions to help resolve complex issues. Her colleagues and leaders have praised her for her diligence, thoroughness, and excellent communication skills. 

But what truly sets Jenny apart is her ability to connect with our members and provide personalized solutions to their needs. Her kindness, empathy, and knowledge have earned her numerous kudos from members and group administrators, who have praised her for her exceptional service. 

Some of the comments that support her nomination include: 

• "The customer service specialist was friendly, knew exactly how to solve my question, and did so quickly!" 

• "She was very courteous, and she resolved my question right away." 

• "Jenny was extremely helpful, answered all my questions, and even went the extra mile to give me the information that she could tell I needed." 

• "Extremely competent and courteous." 

• "Jennifer was extremely helpful and kind. She went out of her way to find a solution to my problem." 

• "Kind, helpful, and knowledgeable all wrapped up in efficiency." 

• "I felt connected and listened to." 

Jenny's commitment to excellence, her passion for helping others, and her dedication to providing world-class service make her an outstanding candidate for the SQM World Class Customer Service Representative of 2024 award. I am proud to nominate her for this well-deserved recognition. 

Sierra Walker – Regence Blue Cross Blue Shield Plans

I would like to nominate Sierra Walker for Customer Service Professional of the Year. Sierra is an outstanding role model for her peers when it comes to customer service. She is constantly going above and beyond for the members who are lucky to get her on the other line. Her ability to maintain composure and empathy on difficult or emotional calls is remarkable. This is reflected in several survey comments and compliment voicemails I have received, but especially on one specific call that stands out. 

In early January 2024, Sierra received a call from a member suffering from a mental health emergency. He hadn’t slept in three weeks, had been through all of the doctors, emergency rooms, and urgent care centers in his surrounding area. The result was the same throughout – nothing was wrong with him. The member was at his wits' end when he reached Sierra on the other line. He expressed fear of losing his life and not making it. Sierra jumped into action. She spent thirty minutes with him, letting him know she was there for him and that she would figure something out, all while researching in the background. Sierra finally found a hospital for him to go to, with all the needed physician specialties on staff and ready to help him. She even took it a step further by calling the facility, advising of the member’s medical issues, and letting them know he was on his way. The member subsequently broke down in shock and relief, stating disbelief that someone would go to this distance for him. 

Sierra prides herself on solving the issue as quickly as possible. She focuses on the issues at hand and doesn’t fret about what comes next. She prefers to remain personable with each member as an individual, while not straying from the tasks at hand. 

Sierra’s voice never wavers. She remains cool, confident, and helpful, no matter the call. She will always go the extra mile when the situation calls for it. 

Our members have terrific things to say about her, and these are just a few of the many compliments we have received: 

• “Sierra was very knowledgeable and pleasant to deal with. She treated me like I was their first call of the day and not however many she’d already been through. It was a great experience, and I appreciated her assistance.” 

• “I just got off the phone with Sierra, and as an industry veteran, I can say that she is a class act! I am thoroughly impressed by not only her efficiency but also her knowledge. She went above and beyond.” 

• “I had the pleasure of speaking with Sierra. I have a mental health issue that my grandson is dealing with, and Sierra went out of her way to make sure she followed all privacy practices to make sure I could receive the information to best help him. You are so fortunate to have her on your team, and I am so grateful I got to speak with her. Mental health is so difficult to deal with and navigate, and to get the help that you need. Sierra came through for us.” 

• “I just got off the phone with Sierra, and I was trying to clean up some benefit questions. As someone who has worked in HR for many years, I can say that Sierra was very clear in her information and how she communicated with me. She was very pleasant and positive in nature. Despite the fact that she probably spoke with a lot of people before me, she still sounded fresh and happy.” 

• “Sierra was the first person to seem to take my problem seriously. She immediately called my doctor and had my account placed on hold while she escalated my claim to be fixed. She was so helpful and pleasant, and competent at her job.” 

Tonya Abear – Regence Blue Cross Blue Shield Plans

I would like to nominate Tonya Abear for Customer Service Professional of the Year. Tonya is an incredibly patient and personable representative. She takes her time on her phone calls, making sure her members feel heard and understood.  

Tonya prides herself on showing her members kindness, compassion, and understanding. She told me, “I try to achieve first call resolution by making sure that our members are getting the resolution that they are looking for, and also by reaching out to providers, when possible, to alleviate some pressure from them, especially when pertaining to upcoming procedures and sensitive issues that our members may be experiencing.” 

Tonya has been confident, empathetic, and passionate since her first day of training. She doesn’t let anything stop her from giving her members the best customer service experience and resolving their issues promptly. 

Tonya has also been working directly with a department dedicated to members facing complex medical issues. She’s taken over many cases of gender affirming care and has quickly become an expert on assisting these members with submitting preauthorization and understanding the process. Tonya prefers to make sure the members are aware of each step, so they don’t feel left in the dark. She follows up as promised, and she doesn’t stop until she gets the resolution she’s working for. 

Other members have terrific things to say about her and these are just a few of the many compliments we have received: 

• “I have been working with Tonya for the past few days, and I don’t normally do this, but I wanted to let you know that she was very helpful. She had an excellent attitude and was patient with me. I was so very happy with her service.” 

• “I wanted to let you know about the outstanding support I’ve been receiving from Tonya. She has been very thorough. I’ve been dealing with an issue for over a year, and she is the one who has given me the greatest support. I greatly appreciate her professionalism, demeanor, and support.” 

• “Tonya called my doctor’s billing center to help resolve the issue while I was on hold. She also kept checking in with me and letting me know what she was doing along the way. She went well above and beyond several other representatives and resolved my issue in 45 minutes.” 

• “I just got off the phone with Tonya and wanted to let you know that she was exceptional at helping me resolve an issue that I had already put multiple hours into. I wanted to say thank you to her and let you know that she went above and beyond to help me get this resolved, better than I had expected.” 

• “I just worked with Tonya, and she was amazing. I have not had customer service like that in years. She was so sweet and outstanding. She helped me so much at such a stressful time in my life, and I really appreciated everything she did for me.” 

Jennifer Schwab – Consumers Energy 

Jennifer (Jenny) Schwab works tirelessly to make sure that her customers are getting the best possible service. She makes sure to explore every available option for the customer. She puts her heart and soul into every call that she takes. 

She had one customer whose services had been disconnected, and his TF balance was over $1,300. I had looked at his account, and he was distraught, clearly struggling. Up until November, he had been making as many payments as he could, but then he stopped. When Jennifer spoke to him, no one had previously been able to help. She wanted to make sure that she was looking at all options for the customer, even if going out of the box was going to be the best option. She helped him to pay the $1,000, and he was in tears. His coworker gave him a credit card to use for payment. She called the customer back after his payment went through and signed him up with a payment plan to make his monthly bills a little more manageable. She also talked to him about the HHC and how to reach out to 211 as she felt he could benefit from some additional help with things like housing and food. When she was finished, he was in tears and told her that she did not know how much weight she had just removed from his shoulders. 

Kimberly LeDuke – Consumers Energy

Kimberly LeDuke is an exceptional agent! Her dedication to customer satisfaction and her ability to resolve issues on the first call are truly commendable. It’s clear that she goes above and beyond to ensure every customer has a positive experience. 

Kim truly embodies the qualities of an outstanding agent. Her genuine care for customers and her determination to find solutions quickly are invaluable traits. This kind of dedication not only resolves issues efficiently but also builds trust and loyalty with customers. 

Kim’s empathy and thoroughness really make a difference. Her ability to understand customers' situations and her commitment to finding the right answer, even if it means consulting with others, shows her dedication to providing excellent service. This kind of approach not only resolves issues effectively but also reassures customers that they are in good hands. 

Kim’s genuine care and determination to find solutions are truly admirable. Her ability to empathize with customers and her proactive approach to resolving issues are key qualities that make her stand out. It’s clear that she goes the extra mile to ensure that every customer feels heard and supported. 

Kim’s politeness, thoroughness, and her effort to ensure that the customers understood her answers are truly commendable. These qualities not only reflect her professionalism but also her commitment to providing excellent customer service. It’s clear that she takes the time to make sure every customer feels valued and informed. 

Just some of the comments taken from Kim’s SQM surveys:  

• “She was able to disconnect my service with no problem, was able to give me as much of the information that she could. She told me what my current bill was and then when I was going to get my final bill. She answered all my questions and then gave me additional information that I didn't know. It was very satisfying.” 

• “She was very friendly and very helpful. She took my call seriously and it was kind of a confusing situation, and she went above and beyond to try to figure it out. I think she did a great job.” 

• “I'm very satisfied because of the nightmare I had for the two calls before that. She took care in what she did. She wasn't sure about the answer, so she went and checked with someone else and came up with the right answer.” 

• “She seemed to show care and really wanted to help me. I had already been contacted, and this made me feel good. I'm quite happy.” 

• “It was funny because we both had the same name. That was one thing. We were joking about that, and she was able to answer my questions and not make me feel like I was a dummy.” 

• “She seemed to generally care about what was going on, and she wanted to get down to the solution.” 

• “She was very knowledgeable and was easy to work with.” 

In recognition of and appreciation for Kim's outstanding achievements of attaining a 91% World Class certification for 2024, we are nominating her for consideration for World Class Agent of the Year. 

Tonya Cunnings – Consumers Energy

I am nominating Tonya for Agent of the Year because she epitomizes exceptional customer service, consistently working to resolve customer issues in every interaction. Tonya begins each call with a positive attitude, ready to tackle any challenge the customer presents. She takes the time to listen carefully and evaluate the situation to ensure she fully understands the customer’s needs. Tonya provides constant reassurance, acknowledgment, and empathy, demonstrating her genuine care for meeting those needs. She goes above and beyond to find the right answers, no matter what it takes. 

In every call, Tonya builds a strong rapport with her customers, creating a sense of trust and understanding. Customer feedback consistently highlights the positive attitude she brings to each interaction and her effectiveness in resolving their issues. Tonya’s dedication to delivering outstanding service and her ability to make customers feel valued and heard make her a truly deserving candidate for this recognition. 

• “She was pleasant. I could understand her. She understood what my needs were. She put in the work order, and I've already heard back from someone regarding that work order. So far, everything has been positive.” 

• “She was amazing. She was very patient with what I was calling in regards to. It's a little tricky to maneuver for both of us, and she handled it very professionally. She told me that she would call me back, and she definitely called me back.” 

• “She went above and beyond to help me with any questions I had. She even looked up stuff for me.” 

• “She was very helpful in trying to help me figure out what might be the issue. She was very friendly. We had a conversation about being a newlywed and having my first home. She was very nice.” 

These examples merely scratch the surface of the excellence Tonya demonstrates daily for our customers. 

In addition to her outstanding service to external customers, Tonya consistently provides the same level of dedication to our internal customers. She is always ready to assist her fellow CSR colleagues, other departments, and even leaders whenever they need support. Tonya steps up to the plate regardless of who requires her help. Please consider Tonya for Agent of the Year, as she truly deserves this recognition and so much more. 

Tim Fisher – First West Credit Union

Tim Fisher is not only a Financial Advisor at the Member Advice Centre of our credit union, but also a problem solver, technology troubleshooter, exceptional listener, and client advocate. There was no better example of this than when Tim spoke with an older member, who had all but given up on the credit union when Tim answered the phone. The member shared that he was so incredibly frustrated with his inability to access online banking that he was ready to close his membership. The member was extremely angry, and the call got off to a rocky start. When reviewing the call later on, Tim admitted that he didn’t know if he would be able to turn the member’s experience around, but that he was going to try. 

Tim and our member were on the phone together for over an hour. They reviewed both online banking and the mobile app, and Tim was able to get to the root cause of the issue and the member’s misunderstanding. Tim was even able to provide some helpful tips and tricks that have worked for others and encouraged the member to practice while they were on the phone together. Over the hour, the member became more relaxed, and the conversation grew to be quite friendly. By the end of the call, the member shared that he now felt confident navigating his online banking, and the extra time and patience that Tim had extended to him persuaded him to change his mind about closing his membership. 

While not all of Tim’s calls have such dramatic turnarounds, Tim consistently delivers world-class professionalism and communication skills that instill confidence and loyalty among our members. His calming tone and the way he carefully and patiently answers questions and explains new technology, especially to those who are new or apprehensive about online banking, build a high level of trust. 

It's worth noting that cyber fraud continues to grow exponentially, and many members are understandably cautious or even fearful of making a mistake online. Tim takes an educational approach that is always encouraging and never condescending. Tim’s survey feedback includes countless notes about his expediency, knowledge base, and excellent service. However, what makes Tim special is the comments about his patience, how he waits on the line to ensure the member’s problem is truly resolved before ending the call, and how he goes “out of his way” to help his members. We should all be so lucky to have someone like Tim on our team, and even luckier if it’s Tim who helps us when we call in. 

Abria Gaynor – Florida Blue, Federal Employee Program 

Going the Extra Mile

My career journey began as an educator, a role that felt natural as I had always aspired to inspire youth and build meaningful relationships that make a lasting difference. In July 2021, I became a mother, and I finally got everything I could’ve dreamt of. However, nothing fully prepared me for the challenges of parenthood. 

My first day at Florida Blue was on September 18, 2023, and I was completely overjoyed to get into a new field. I displayed an eagerness to learn. Shortly after embarking on my new career journey, I was met with unexpected adversity. In November 2023, my daughter was diagnosed with Level 3 Autism, Global Developmental Delay, and hearing impairment. It was just like I went to bed one night as an employee and woke up the next day as a member. My perspective shifted; I was no longer just an employee, I became a member, navigating the same system I had been trained to support. Suddenly, I found myself making the same calls I once answered, asking about benefits, out-of-pocket costs, and claim disputes, feeling overwhelmed and unsure of where to start. 

I was the one who needed assistance, not knowing what to do and feeling completely overwhelmed with uncertainty, while also dealing with the emotional side of what life will look like for my family now. Through this experience, I gained a profound understanding of what it truly means to be a member. I experienced firsthand the emotional weight and uncertainty that many members feel. Florida Blue provided me with the knowledge and resources that prepared me as both an employee and a member. 

Initially, I spoke to members with empathy, but it wasn’t until I walked in their shoes that I truly understood their struggles. This realization ignited a new purpose in me. I wanted to bridge the gap between Florida Blue and its members, just as the company had done for me. I began to treat each member as if I was speaking with my mom, sister, grandmother, or even my daughter. The Florida Blue members became my family. As a service advocate, I had to ask myself: “If this were my loved one, how would I want them to be treated?” My passion for assisting members grew, and my determination to resolve their concerns deepened. Every morning, I clocked in with a smile, not because every day is easy, but because I knew my members needed me just as much as I needed them. 

One experience that will stay with me forever was a call from a newly divorced mother whose son had been diagnosed with ADHD and Autism and was non-verbal. The mom called into Florida Blue, frantic due to several denied claims. I could hear the frustration, confusion, and sadness in her voice. Before I could even greet her, she broke down in tears, apologizing. Holding back the tears, I silently told myself: “Today, I’m going to make a difference for this member.” By the end of that call, she expressed heartfelt gratitude, “I’ve never had a health insurance company that truly listened and cared. You handled my situation with such care, provided additional resources, and resolved my concerns.” This was my very first Kudos Call. I never knew how big an impact that would make on my daily life as well as my continued career journey here at Florida Blue. 

Several months went by, and this member recalled my name and requested to speak with me directly. Upon transfer, she wanted to let me know that working with Florida Blue and because of my attentiveness to her needs, she now knows she made the right choice in health insurance for her family. Florida Blue continues to push me to strive higher, and with that encouragement, I’m making a difference one member at a time, confirming I’m on the right path. My efforts have not gone unnoticed. SQM surveys have validated the impact of my work, and within a year, because of my effectiveness, my manager began placing me in new spaces where I could assist my colleagues, sharing insights on how to provide World Class Customer Service. Through storytelling and shared experiences, I realized that my influence extended beyond members—it also inspired my peers. 

Every day, I lead with a smile, knowing that I might be the light someone needs. Being part of the Florida Blue Federal Employee Program has allowed me to become an extension of the company’s mission: helping people and communities achieve better health. My journey has come full circle, and with every interaction, I hope to continue bridging the gap, offering empathy, dignity, and an unwavering passion to serve. 

Alahna Bacheler – Florida Blue, Federal Employee Program

When I was younger, I was always by my mother’s side during her doctor’s appointments and hospitalizations, as she fought a chronic gastrointestinal disorder. She often spoke proudly of her exceptional insurance, highlighting how it made managing her health possible. Little did I know, 23 years later, I would be a part of her federal insurance and become an advocate for members like my mother. 

I joined Florida Blue with a mix of nerves, weariness, excitement, eagerness, and determination. Amid all these emotions, my focus was to become a successful customer advocate, dedicated to supporting all our members. 

On December 13th, 2024, I received a call that made me believe in destiny. It may sound cliché, but our member felt the same way. She initially called seeking help with maternity benefits, but as we spoke, she shared that she had recently experienced a pregnancy loss. The way she described her grief and what she had gone through truly shattered my heart. My voice became choked, tears filled my eyes, and chills ran down my arms. I expressed my deepest sympathy and told her, "You are seen." Those words resonated with her, and in that moment, we shared something deeply personal. As women, we can only truly understand and comfort each other through the pain and isolation of such a loss. 

We went through her benefits in detail, and she was surprised to learn about all that we offered. She expressed a desire to be "prepared" for everything, so I made sure to add a personal touch, both as a mother and as her advocate. When we got to postpartum care, I emphasized how much FEP values mental health support, especially for new mothers. I explained that we cover therapy for women after childbirth, which is incredibly important. Speaking from my own experience, I shared how challenging postpartum can be—isolating, frightening, and a deeply personal journey with no right or wrong way to heal. 

We also talked about breastfeeding, and she was adamant about wanting to breastfeed. I wholeheartedly supported that decision and informed her that we would cover breast pumps, storage bags, and everything needed to make her breastfeeding experience successful. We went through every benefit, one by one, reassuring her that she would have all the support she needed during and after her pregnancy. She was thrilled, taking notes as we spoke. 

Our conversation lasted nearly 2.5 hours, filled with personal, raw, and valuable information. My team lead and supervisor even checked in on me to make sure I was okay. Honestly, I was more than okay—I was fully engaged, dedicated, and excited to give our member the positive experience she deserved. There was an undeniable connection between us that felt like destiny. She needed someone who understood, someone who could offer support, love, and reassurance that this pregnancy would be different. 

By the end of our call, she was prepared, comfortable, and excited for what the future would bring. To this day, she still makes sure I know the gender of her future FEP baby, whether she reaches out to me directly or tells another representative. This experience was truly one-of-a-kind, creating a bond that went beyond the call itself. It was a connection that I know we both experienced and will carry with us forever, as women and as mothers 

Before open season, FEP began looking for Postal customer service advocates, and I eagerly volunteered. Why, you ask? Because I’m a "postal baby." Both of my parents worked for the postal service and have since retired, which gave me an advantage—I'm familiar with the ins and outs of everything Postal. During the postal PSHB transition, many of our members were feeling stressed, anxious, and uncertain. However, my personal experience allowed me to bring clarity, confidence, and understanding to the PSHB members I communicated with. 

By sharing that my mother is a retired postal worker and that I am her “personal PSHB advocate,” our members seemed to really connect with me. They often tell me I need to let my mom know that she raised me right and that she’s lucky to have me. It brings me so much joy to help ease the stress and uncertainty our members were facing. I’m truly grateful for the opportunity to make such a positive impact. 

Every day, I am determined to provide World Class Customer Service for our members, and in return, I have been given several opportunities by my superiors. After completing my training, I was entrusted with the responsibility of handling voicemails for FEP, and eventually for PSHB voicemails. I can honestly say I enjoyed every moment of it. Then, my supervisor gave me the task of training a fellow advocate who had missed training due to personal reasons. Though I was nervous, I was excited to embrace this opportunity. I made sure to take the time to ensure she felt comfortable in her role and had all the resources necessary to be a successful and strong advocate for our members. She later told me that she "understood why they chose me to train her" and that she believed I would go far in this role. 

Now, onto my latest adventure! I’ve recently learned secure messaging, and I jumped right in. There’s so much to learn, which only fuels my eagerness and determination to continue growing in my role at Florida Blue. 

Marnee Heppner – HCSC FEP

What would you do with an extra $11,000? I don’t know what I would do personally, but Marnee Heppner helped a member contact the Office of Personnel Management (OPM) to attempt to recoup overpayments in excess of $11,000! After a lengthy discussion between the member, OPM, and Marnee, OPM agreed to issue a life-changing refund. Imagine the impact this one act of service had on our member. Her willingness to do the right thing makes Marnee stand out among the best; she is deserving of Agent of the Year.  

This is only one example of how Marnee has been a beacon of light to our members. Every month, without fail, there are multiple survey responses singing praises for the excellent service she provided and the fantastic level of care and compassion she provided to her callers. A few additional examples are shown below: 

• “She wanted to take care of my request right away. I've never had that happen before. When the system wasn't working for her, she did it another way and provided what I needed, immediately.” 

• “The customer service rep I spoke with is very knowledgeable and extremely helpful. She was able to answer all my questions, and she sent me a form that I would need to use to request preauthorization. She's an outstanding representative for your company.” 

• “Marnee was very good. She took us all the way through the whole process. My wife has just signed up with Medicare. We were trying to link Medicare with our Blue Cross Blue Shield FEP basic plan. She initiated a 3-way call with Medicare, and we got everything done. We only had to deal with her, and she was wonderful! Everything was done to our satisfaction. We were very happy with her!” 

• “She worked very hard at finding out what the problem was with my payment and my coverage. She spent a lot of time with me, asking me questions. She made a phone call to OPM and determined that the problem was with OPM. Then she called my doctor and explained that I was covered. She did everything possible, and she was very kind, and I really appreciated it.” 

• “Very efficient. She was concerned about me and my well-being and what was best for my overall care, and she was very helpful. I really appreciated her and the time that it took her to resolve my issue.” 

Priscilla Gutierrez – HCSC FEP

I would like to nominate Priscilla Gutierrez as Agent of the Year for 2024. Priscilla is a dedicated agent who is knowledgeable, personable, and professional in handling all of the needs of a member so that all of their issues are resolved in one contact. Her navigation of our internal systems leads to tremendous efficiency. Four comments on SQM surveys say, “She was very polite and very efficient, and answered all my questions immediately,” “Very professional and very proficient,” “Very helpful, very professional, nice person,” and “She knew what she was doing. She went straight to what I was looking for and was able to get my questions answered.” 

Here are a few other comments we have received about her handling of calls: 

• “The person was not in a rush and stayed with me on the phone at all times, was polite, explained what was going on, and helped me out with every question to include a summary to make sure I had the proper information.” 

• “She was very concerned about my situation, and she worked very hard to satisfy my questions, to understand, and seek an answer to my question. I appreciated her effort.” 

• “The customer service rep I spoke with was able to troubleshoot the problem that I had and answer questions I didn't even realize that I needed to ask. She was able to get through, and she found out a lot of additional information I didn't even know was going on behind the scenes, and it was rectified.” 

Beyond those comments, however, are the things she does when no one is watching. I reviewed a call at random from a member late in the afternoon, and she had taken the call at 9:30 AM. When I went to the notes, I saw a lot more than I expected because the notes were finalized around 3:00 PM. We needed a file updated, and we had received everything we needed in writing, and the member called merely to confirm receipt. Priscilla gave a reasonable time frame of 15 days to process the items we received, but didn’t allow it to take that long. She sent the information to another department to expedite. She tracked the progress. Once the update was made, Priscilla looked at everything else the member needed for their inquiry to be completed and took those actions, adjusting about 15 claims, throughout the day before closing her notes. She didn’t tell me, her supervisor, that she had done this. She didn’t make it a point that anyone knew she went above and beyond like that. The member didn’t even know because they were fine with 15 days.  

When you happen upon something like that, it’s highly unlikely that it’s a rare occurrence. Priscilla’s mindset is to make sure that the person on the other end of the phone has all of their needs met. She’s also a mentor to other representatives through our learning coach program to ensure the next group of representatives will provide the same concierge care they have come to expect from people like Priscilla. 

Larry Davies – Marchon/Altair

In the world of customer service, emphasis is usually placed on efficiency, and representatives are trained to resolve issues as quickly as possible. However, this is not necessarily the case at the call center. Representatives are empowered to “think outside of the box” and provide exceptional service, all without having to worry about the intimidating “Average Handle Time” statistic. 

It is because of this forward-thinking and customer-driven mindset adopted by Marchon/Altair that I was able to have the following interaction with one of our accounts. An interaction that I am certain had an equally profound impact on the account as it did on me. 

It was a typical day thus far, when I heard that familiar tone in my headset, a sound that signals to my brain my absolute best was being called upon. On the other line was a very soft-spoken Sarah, and after opening the call with my standard greeting and a brief exchange of pleasantries to establish a rapport, I asked, “How may I be of assistance, Sarah?” To which she replied, “I am hoping for a miracle!” It was at this moment that I realized I had to don the cape of exceptionalism, and I knew that with that power came great responsibility. Sarah let me know she was looking for a frame that she no longer saw online but was hoping we still had the frame in stock. 

In my most optimistic voice, I let her know I would be more than happy to check availability for her and entered the frame information into my system. To both our dismay, the frame was no longer available and completely sold out. After delivering the news, Sarah let out a sigh of disappointment, or dare I say defeat. Sensing her disappointment, I then asked her if this was a patient reorder or the reason she was inquiring about this frame. 

Sarah let me know that she had a young patient who really loved his Nike frames, but unfortunately, due to a defect, his frame broke. She was hoping the frame was still available so she could replace it for him under warranty. On hearing this, I began to smile because Marchon has a procedure in place to resolve exactly this type of situation. I was about to be her hero, I thought to myself. In my most confident voice, I replied to her, “No need to worry, Sarah, we will still honor the warranty and I will be more than happy to find you a few similar frames that we can send to the office so you can have your patient try them on and choose the frame he liked the best”. 

Imagine my surprise when Sarah’s response was not very enthusiastic, and she let me know that she was aware of our procedure, but this would not work for her patient. She went on to explain that her patient lived far away from the office, and making multiple trips to the office would be a challenge because the family did not have a car. I actively listened to her concerns and empathized with her and her patient. I realized that going through our restyle process would mean her patient would go weeks without his glasses due to these challenges. 

Being a VSP Vision employee, where our company’s mission is to help people see, I knew I had to do more. Seeing that our conventional options would not be an appropriate resolution, I knew I had to employ “out of the box” thinking to resolve the issue. I took a moment and, with Uncle Ben’s word resonating in my head – “With great power comes great responsibility” – I said to myself, “I’ve got this!” 

I said to Sarah, “I understand your situation and agree that our standard procedure may not be the best resolution. I have another not-so-conventional solution we can try, if that will be ok with you?”  I could feel Sarah’s renewed enthusiasm as she emphatically said, “Sure!” I advised her that I would reach out to her Nike sales representative to see if they may still have the frame in their sample bag, and if not, I would collaborate with the representative to see if any other accounts in the area may still have the frame. Sarah agreed, so I let her know I would give her a call back before the end of business with an update. 

As I heard the clicking of Sarah ending our call, I sprang into action. I placed a call out to Sara’s Nike representative, which went unanswered, so undeterred, I resorted to an email instead. Knowing that time was of the essence, I also proactively sent the representative a list of accounts that recently purchased the same frame and their respective contact information. 

As the minutes turned into hours and I continued through my workday, Sarah and her patient persisted in my mind. I would ever so often check my emails to see if the Nike representative responded, but there was no response. As my anxiety increased with the day’s end getting closer, I heard another tone, this time not because of a call coming through, but rather an Outlook notification. 

You guessed it! It was an email from the Nike representative. It said, “Hi Larry, I apologize for the delay in my response, but unfortunately, I no longer have that frame in my sample inventory.” It was like time stopped, but the email continued, “However, I was able to call the offices you sent me, and one of them still has it. I will be heading there later this week to pick up the frame and will drop it off for Sarah.” 

I was elated! I felt a deep sense of accomplishment and knew the best part was still to come. I called Sarah and let her know the great news. She was overly excited, to the point where I felt that if I had been there in person, she would have hugged me; she even said she would in her initial response to the good news. She continued to thank me profusely for helping her and, most importantly, her patient. I responded in kind and thanked her for her patience and her willingness to collaborate with me. 

In conclusion, the interaction with Sarah will stay with me for a long time. The levels of fulfillment and accomplishment that I got from this interaction have served to reinforce my belief that an exceptional customer goes beyond following procedures. Providing exceptional service entails understanding individual circumstances and being willing to adapt to each one. Many would say that I was just doing my job, and this is the truth. However, I will only accept this as a critique from my colleagues and coworkers here at Marchon / Altair, where going above and beyond is the norm, and interactions like these are just another day at the office. ​​​​​​​

Michael Droll – Marchon/Altair

I recently had a conversation with a member who was deeply concerned. Like so many others in California, their practice has been significantly affected by the recent, devastating wildfires. The fires have brought widespread destruction and hardship, and their office and countless others are struggling to navigate the aftermath. Tragically, one of their young patients, already dealing with the trauma of the fires, lost absolutely everything, including their essential eyeglasses. They were in desperate need of a replacement LR4000 frame, and understandably, time was of the essence. 

Knowing the incredibly difficult circumstances they were facing – the wildfires, the disruption to their practice, and especially the hardship this young patient was experiencing – I immediately made their request my top priority. I did not just expedite the order; I wanted to do more. Recognizing the immense challenges this patient and the entire community were enduring during this incredibly challenging time, I wanted to leverage the "VSP Power of YES" to make a real difference. It was crucial to go the extra mile, so I took the additional step of waving all charges for the frame. 

When I shared the news with Trish, her relief was palpable. She was incredibly grateful for this gesture, expressing how much of a difference it would make for her young patient. She explained how this small act of kindness would bring a bit of much-needed relief during such a challenging and traumatic time. Knowing that we could help in some small way during this crisis and bring a little bit of comfort to someone who had lost so much was truly rewarding. It reinforced the importance of what we do and the positive impact we can have on people's lives, even during the most challenging times. 

Connor Armstrong-Centeno – Mr. Cooper

Connor Armstrong-Centeno embodies what it means to be CSR of the Year. His keen ability to resolve matters quickly while maintaining a positive attitude sets him apart. He truly cares for his customers. 

• "Connor was very professional. When he called me, I was in the middle of a situation, so I was aggravated. He didn't have good news for me, so I was not happy. He was able to, with customer service skills, turn the situation around and assist me. At the end of the call, I was relaxed. I felt like I had done something. I felt like there was hope. Connor was amazing! I work in customer service myself, and I know it's not easy, and I really appreciate that he was the one who was on the other side of the phone call. I needed someone who had patience, and that was clear. Personally, he was able to understand me. I felt I was understood. I was helped. I was given hope. He listened. Connor was amazing, and I cannot say enough." 

This customer's testimony is one of many for Connor. He strives for excellence and is determined to provide great customer service. Connor shows empathy and patience while creating a comfortable customer experience. He leads by example by following up with customers until the issue is resolved.

Johnie Devine – Mr. Cooper

I would like to nominate Johnie Devie for the 2024 SQM CSR of the Year award. Johnie has committed herself to ensuring she always leaves each customer with a warm and fuzzy feeling of delight. Johnie takes pride in ensuring each customer feels valued, heard, and receives a complete resolution that they can be fully delighted with. Her main concern is to always ensure she delivers excellent quality work and customer service in all she says and does. She takes the time to explain in detail the resolution in an easy-to-understand manner, all while maintaining a smile you can hear in her voice and while being polite and professional, no matter who she comes in contact with. 

We can see this in her 51 WCC SQM Surveys and her 93% average. No matter what is going on in her personal life, she leaves it at the door and shows up for her customers with a can-do attitude in every instance. One example of this was a customer who had recently lost her mother and had been trying for 4 months to get details on how to oversee the mortgage account going forward. On the day Johnie received the call, the customer had called three other times, disconnected, or had been transferred to the incorrect department. Johnie immediately showed empathy, care, concern, and took complete ownership of the call. She answered all the questions they had for her, explained the transfer of the call, and the department needed. She took the time to warmly transfer the call and provide the complete details to the next agent, so they understood how to complete the resolution. Because of Johnie’s patience, going the extra mile, and truly understanding the resolution needed, a frustrating situation was resolved in 6 days due to the appropriate steps taken.  Johnie changed the customer’s perspective of the company in a matter of minutes. 

Direct commentary from customers includes feedback that she was personal, kind, professional, friendly, efficient, knowledgeable, pleasant, genuinely nice to deal with, and took care of the situation, just to name a few. These are just a few of the examples of the radical customer service that Johnie delivers every day. Johnie wears and takes pride in displaying the Mr. Cooper values every chance she can get. Her positive approach and commitment to excellent customer service make her a winner. 

Lanette Brooks – Mr. Cooper

Lanette is ideal for CSR of the year because of her excellent customer service skills and empathy shared throughout her calls. 

When you show empathy to others, you are making a difference. Lanette has one of the best tones during her calls. She is attentive to detail, and if there's anything she doesn't understand, she is sure to involve others to assist her customers and achieve full satisfaction. Lanette had a difficult call where the customer didn't understand the Private Mortgage Insurance (PMI) removal process. The loan had just transferred to MRC, and the customer didn't believe in us. Lanette went above and beyond to make sure the customer understood the calculations, values involved, and the loan value required. She explained the process a couple of times without any luck, but she didn't give up. She took control of the call like no other. She started from the beginning of the loan processing and explained how PMI was set on the loan. She explained in detail all that PMI involves and changed the customer's attitude about MRC by the end of the call. The customer had given up on us since we were their new servicer, but thanks to Lanette, we have a satisfied customer for life. He explained how everyone had given up on him, but not Lanette. She was ready to assist and reworded the process to make sure the customer understood. He was able to remove his PMI a few weeks later, and he said Lanette made a huge difference by being extremely patient and not giving up on him. 

Mayra Munoz – Mr. Cooper

Mayra truly exemplified outstanding customer service by turning a dissatisfied customer into a delighted one. This customer was frustrated with their loan transfer to MRC, the systems, and the servicing process. However, Mayra not only resolved their issue but also left them singing her praises. 

The customer expressed their appreciation, stating: 

• “Mayra was very knowledgeable, very polite, and then helped set up autopay on our account, which had just transferred for servicing. The letter we received said everything was set up, but when I called two months ago, they assured me it was fine. Then I discovered autopay was not set up. I had to re-enter all the information, and it was confusing. Mayra walked me through the entire process. It’s usually very difficult to get a live agent, but when I finally reached Mayra, she was excellent, and I gave her an outstanding rating today.” 

This is what customer service is all about. It’s about putting ourselves in the customers' shoes, taking ownership of their issues, and not just telling them how to fix it, but staying on the call to guide them until everything is resolved. Mayra’s dedication ensured this customer’s long-lasting satisfaction. 

What’s even more impressive is that Mayra not only accomplished this on one or two calls but achieved an outstanding 94% satisfaction rate in 2024, the highest satisfaction rating in Private label. This is no easy feat, but when you put your heart and soul into your work, success is inevitable. Well done, Mayra!

Zantasia Jackson – Mr. Cooper

I am pleased to nominate Zantasia Jackson for the SQM 2024 CSR of the Year Award. Zantasia consistently goes above and beyond in her role as an agent, demonstrating exceptional customer service that not only delights our clients but also sets an inspiring example for her colleagues. 

Zantasia’s journey with our company has been remarkable. She started with the Private Label team, where she quickly became known for her dedication to providing outstanding service. In October 2024, she was promoted to the Rushmore brand, where her performance has only continued to shine. Her adaptability and strong work ethic have made her an asset to the new team, where she has continued to exceed expectations. 

1. Creating a Positive and Memorable Customer Experience: 

Zantasia is known for her ability to create positive and memorable experiences for our customers. One such instance involved a long-time client who was facing multiple issues with their account. Despite the complexity of the situation, Zantasia remained calm, empathetic, and patient, ensuring the customer felt heard and valued throughout the entire process. She worked tirelessly to resolve all issues and even followed up with the customer to ensure that they were completely satisfied. The customer expressed immense gratitude, sharing how Zantasia’s professionalism and kindness turned a frustrating situation into a positive experience. 

2. Going the Extra Mile to Resolve a Difficult Customer Call: 

On another occasion, Zantasia handled an extremely difficult call from a frustrated customer who had been bounced around between multiple agents. Instead of simply resolving the issue and ending the call, Zantasia took the time to listen to the customer's frustrations and ensured that all concerns were addressed. She followed up with internal teams to expedite the resolution and provided the customer with regular updates. By the end of the call, the customer was not only satisfied but also expressed that they felt valued by the company. 

3. Turning a Dissatisfied Customer into a Satisfied One: 

Zantasia’s ability to turn a dissatisfied customer into a raving fan is truly remarkable. A particularly challenging case involved a customer who had experienced significant delays with a specific service. The customer was extremely unhappy and expressed doubts about continuing to do business with us. Zantasia empathized with the customer’s frustration and provided a clear plan for resolution. By the end of the interaction, the customer was not only satisfied but praised Zantasia for her dedication, which ultimately strengthened their loyalty to our company. 

4. Inspiring Others to Provide Great Customer Service: 

Zantasia’s commitment to exceptional customer service is contagious. She consistently inspires her colleagues with her positive attitude, dedication, and work ethic. Her willingness to share knowledge and offer support to her peers creates a collaborative and supportive work environment. Zantasia frequently receives compliments from her colleagues, who cite her as a role model in customer service. Her ability to inspire and motivate others to reach the same high standards of service is a testament to her leadership qualities. 

In conclusion, Zantasia Jackson exemplifies the qualities of a top-tier customer service representative. Her dedication to ensuring every customer is heard, valued, and satisfied has made a lasting impact on our clients and our company. From her success in Private Label to her outstanding performance with the Rushmore brand, she continues to demonstrate excellence in all aspects of her role. I am confident that Zantasia is deserving of the SQM 2024 CSR of the Year Award, and I look forward to seeing her continue to excel and inspire others. 

Marsay Garner – Regence BCBS

In an astonishing display of dedication, expertise, and compassion, Marsay Garner has risen to the top of her program in a remarkably short period of time. Despite joining our company in April 2024 and only starting to take calls in June 2024, Marsay has achieved a 97.56% World Class certification – the highest in her program. This is a testament to her exceptional skills, her passion for helping others, and her unwavering commitment to excellence. 

In just a few short months, Marsay has made a profound impact on our organization and our callers. She's a shining example of what it means to be a world-class agent, and her achievements demonstrate her hard work, dedication, and natural talent for customer service. 

Marsay's unique blend of empathy, expertise, and advocacy sets her apart from her peers. She approaches each call with a deep understanding of the caller's needs, concerns, and emotions. She listens attentively, asks probing questions, and provides clear, concise explanations that empower callers to take control of their benefits and resources. 

One call that stands out involved an emotional parent who had just received devastating news about a mental health diagnosis for their dependent. The member knew there was a long road ahead with many appointments and insurance requirements, which was overwhelming to understand after receiving such news. Marsay's compassion and kindness were palpable as she listened to the caller's concerns, reassured them that they were not alone, and provided guidance on the next steps. She took the time to clearly explain what to expect, ensuring that the member had a clear understanding of the process. She also reached out to the provider's office to confirm the benefits needed and helped clarify the next steps, streamlining the process for both the member and provider. The provider mentioned multiple times how impressed they were with Marsay's advocacy on behalf of the member, noting they had never had an insurance company make outreach to help a patient in this capacity. This clarity and transparency helped alleviate the member's fear and stress, enabling them to feel more in control of their situation. The caller's feedback on the SQM survey highlighted Marsay's exceptional skills, stating, "All of my questions were answered completely, and the representative took the time to explain things that were necessary." 

The feedback from callers and providers alike demonstrates Marsay's exceptional service. Here are just a few examples: 

• "She helped me with a complex issue and was wonderful to work with." 

• "She's been really great helping me work through a claim issue. She's communicated timely and has been wonderful." 

• "She helped me with a convoluted question and deserves a gold star for the day." 

Marsay's achievements extend beyond her exceptional service. She's also a leader and role model within our organization. She volunteered to help with our Action Alert team, providing support to callers who need extra guidance. She's also our go-to expert for best practices and information on complex emotional calls. 

Marsay's rapid rise to the top of her program demonstrates her exceptional abilities and dedication to excellence. She exemplifies what it means to be a world-class agent, and her achievements reflect her hard work, dedication, and natural talent for customer service. I'm honored to nominate her for World-Class Agent of the Year, and I do not doubt that she will continue to inspire and delight our callers for years to come. 

Sarra Woods – Regence BCBS

I would like to nominate Sarra Woods for Agent of the Year. 

In 2024, Sarra earned two distinguished service hero nominations that exemplify her exceptional dedication to member service. The first nomination showcased her remarkable persistence in resolving a critical medication access issue. When a member's husband couldn't obtain needed medication due to an eligibility communication issue, Sarra took extraordinary measures to resolve the situation. Despite initial roadblocks with the Membership team, she persisted in her investigation, working directly with the employer group to discover that a single unchecked box was causing the delay. Sarra coordinated with multiple departments, expedited paperwork processing, and ensured same-day updates to the external pharmacy team. Her commitment to follow-through didn't end until she personally confirmed the member's husband could access his medication. 

The second nomination highlighted Sarra's ability to transform negative experiences into positive ones. Faced with a member who was initially disappointed with their Regence experience, Sarra's calm demeanor, patience, and empathy created an immediate connection. Her problem-solving approach and dedication to finding the right solution helped the member feel heard and valued, completely turning around their perception in a single call. 

The 2024 SQM survey feedback consistently reveals Sarra's exceptional commitment to thorough service. A particularly touching testimonial came from a member undergoing chemotherapy: "She took extra time to solve my problem, understand my situation with going through chemo, and her extra efforts have helped actually save me a bunch of time on my personal time, and I greatly appreciate her. She is an excellent customer service rep and deserves a raise, and this is coming from somebody who's an assistant nurse manager." 

Members frequently praise Sarra's methodical and comprehensive approach. One member shared: "She was knowledgeable. I had multiple questions. She called my provider. She resolved the issue. She made sure that I understood what the problem was, and was very respectful and cordial. She was amazing, one of the best customer service calls I've ever made." Another member highlighted her persistent follow-through: "She continued to help me as a customer of Regence to work with Evergreen Health and try to make them understand what was needed. She and I kept in touch, either with a call from me or a call from her. She’s a wonderful customer service rep." 

Sarra's communication style consistently earns high praise. Members note she is "Very polite and willing to explain and reexplain the questions that I had until I completely understood it." Even in challenging situations, such as long hold times, she maintains exceptional service: "I was on hold for a very long time, but she continually checked in to make sure that I was okay continuing to hold, and she was very pleasant." Members routinely describe her as "knowledgeable and sympathetic," "very thorough and professional," and "courteous and clear." 

Her impact extends beyond individual interactions to build lasting trust in our organization. One member noted, "Sarra was very helpful, answered all my questions, and that's the way it always is with Regence. Everybody is always professional and great." Her thorough approach to problem-solving is evident in another member's comment: "She fully researched the issue that I was having and was able to give me a reference number and to call my providers about what I was facing in terms of insurance coverage." 

Sarra's service style combines efficiency with genuine care, technical expertise with emotional intelligence. Whether helping members navigate complex healthcare situations or addressing routine inquiries, she consistently demonstrates our core values. Her proactive approach ensures members receive complete resolutions rather than temporary fixes, while her empathy helps ease their concerns during stressful situations. 

Sarra's two service hero nominations, combined with overwhelming positive member feedback, showcase her exceptional commitment to member service. Her dedication to excellence, ability to handle complex situations with grace, and consistent positive impact on member experiences make her an outstanding candidate for Agent of the Year. 

Jason O’Connell – Security Health Plan

Growing animosity towards the health insurance industry has challenged customer service teams in this sector across the nation. Rising costs, plan complexity, and uncertainty of future health create vulnerability amongst customers. Achieving first call resolution has become increasingly difficult with a negative public perception of health insurance. This perception requires customer service representatives to be more empathetic, knowledgeable, and to act as advocates for members. I’ve had several opportunities to put these skills into action to make a profound difference in members’ lives. 

One memorable interaction where I felt I made the greatest difference began with a frantic phone call from an elderly member sobbing, “I need help. I’m in so much pain. I can’t go on another day living like this. I would rather end my life than carry on in this manner.” She needed a procedure to drain fluid from her hip, which was causing pressure and intense pain. Pain medications were not working. Her physician notified her she would require surgery; however, this could not be scheduled for another month. The physician was also not communicating with the insurance company, which was causing a delay in approval for the procedure. I felt empathetic towards her situation but had no control over improving her pain. However, I did know connecting her to a social worker could keep her safe while I found a resolution to her problem. 

After connecting her with crisis support, I began to investigate why there was such a delay in her care. First, I contacted the physician’s office, where I discovered an authorization request was never sent to our insurance company due to a clerical error. To prevent another wait, I gathered the authorization information over the phone and relayed this to the review team. This was quickly approved, so I again contacted the physician’s office to see if her surgery could be scheduled in a timelier manner. After collaborating with the surgeon, radiology team, and care manager, the surgery was scheduled for a few days later. 

When I was able to reach the customer and convey the good news, she was ecstatic and extremely grateful, but I could still hear hesitation in her voice. She expressed concerns about healthcare costs. After reviewing her plan with her, I helped her realize that her plan would pay for all but a nominal co-pay for the procedure. The co-pay wouldn’t need to be paid up front either; the cost could be spread out with a payment plan. The interaction was very emotional; she went from feeling vulnerable to feeling that she was supported. Days following her surgery, the social worker reached out to her. She passed on the following message, “Jason is the best and was the one individual who cared the most. I truly appreciate what he did for me”. 

Not only did my knowledge and compassion create a positive outcome for this specific member, but it also helped me realize how much of an impact I can make with each phone call I answer. By advocating for members in the future, I hope to change the perception of health insurance to a positive one. 

 

Background Written by Katie Johansson – Workforce Analyst: 

Jason O’Connell has been with Security Health Plan since July 2014. He has been a huge part of Customer Service’s success over the years with his outstanding Customer Service and expertise in the department. Jason helps out with many different areas and is a subject matter expert in numerous key processes. Jason O’Connell was SQM’s Agent of the Year in 2020, and we were so proud of him and our Customer Service team here at Security Health Plan. 

Jason is trained on all product lines and is a licensed Benefit Specialist. He works across multiple channels, including live calls, chat channels, concierge, and escalation lines. Jason always has a willingness to help out and pick up any extra duties that need to be done. He has the most calming voice, and everyone who speaks to Jason feels heard and knows that he will do everything in his power to help them. He is a great team player and leader in the department. Jason is so genuine and sincere in his interactions. 

Jason saw improvement across all KPI’s in 2024, which was very impressive considering he was already performing at a high level. He finished 2024 at 92% FCR, 98% Call Resolution, 98% CSR CSAT, and 97% World Class. This was a 5% increase in FCR, 4% increase in Call Resolution, 2% increase in CSR CSAT, and 4% increase in World Class. 

Jason has received a lot of outstanding feedback on his surveys. Below are some of the comments received in 2024: 

• “I called because I had a question, & Jason answered my question, very politely told me other information I did not know, a wonderful phone call. Thank you, Jason.” 

• “This call was a delight. The gentleman on the other end of the line was knowledgeable, he had a sense of humor, and was eager to help.” 

• “Got to talk to someone immediately, and the representative was pleasant and knowledgeable.” 

 

Feedback from Call Coach Sarah Ford:  

“The rep was quick with responses to questions asked. He was very on point. His answers were specific in nature, which guided the conversation to a great resolution in a short time. His responses were professional and pleasant at the same time. He was very knowledgeable, which kept me at ease to ask follow-up questions. This rep is an asset to Security Health, and I thank him for his patience and understanding to my queries.” - Feedback from member Cathy on her experience with Jason.  

Jason O’Connell continues to inspire me with his dedication to member experience. Reading Cathy and other member’s feedback on their interactions with Jason highlights his level of commitment and competence. 

In Cathy’s case, her premium was raising – something no one wants to deal with. Jason was able to offer different plan options that might better suit her needs and assist with the cost. When Jason isn’t helping members find cost savings, he is assisting in other ways.  

Jason preforms a number of roles in customer service to help our members. He works as a concierge for members with complex medical issues, so they can get the help they need with the same agent. This helps lower the members’ frustration because they have someone who knows their specific situation and they now have personalized assistance. He is not afraid to reach out on the members’ behalf. He strives to resolve all issues and never leaves the member with homework.  

Our member Valerie says of Jason: “I spoke with representative Jason. I was calling to verify if my family doctor was still in network. It was verified that she was. I also asked about a bill I received for an X-ray in 2023, and was told that he would speak with the billing hospital and find out why I am being billed for the balance of the bill after insurance payment. Jason was very easy to talk with and was able to answer all of my questions. This is the first time I have left an insurance call with a positive experience. Thank you, Jason!” 

Valerie was concerned that her X-ray was not getting paid properly, and she needed to make sure her out-of-state provider was still affiliated. Jason confirmed her provider was affiliated, helped her find a few more providers, and then reached out to the medical facility to resolve her billing issue. Our member had a $0 responsibility. It was a huge weight lifted off her shoulders.  

When Jason is not going above and beyond and solving complex situations for members, he is looking to the future with alternative member experiences. He assists with member emails and chats, answering questions and assisting as needed. 

He also helps with complex Diversified Benefits (DBS) and Employee Benefit Corporation (EBC) issues. He makes sure members are getting reimbursed for their medical expenses. 

Our member Jerri rated Jason as being an Outstanding Example of customer service after he helped her with a billing issue, finding coverage for her son, and talking plan options: “I had multiple questions, he listened and helped with each one. I told the representative on the phone yesterday, I will never leave Security Health, mainly because of their customer service. Health care is hard to manage, but I have never once called Security Health with a problem and not had someone happy to try to help. A+ rating for customer service!” 

Finally, Jason helps members by assisting in the department. He volunteers with the help desk to assist other agents with member inquiries, and he is always willing to jump in to help with complex issues and offer valuable insight on member experience and department procedures. 

I feel that our member Jayne ultimately sums up the member experience with Jason: “The representative that helped me was very upbeat and pleasant to talk to. He was quick to find my account and was very knowledgeable. In a matter of minutes, his explanation answered my questions. Usually, when one calls a call center or uses a chat box on a web page, there is a wait, sometimes a really long wait. The call can seem so impersonal. I have trouble understanding accents that some people have. This call was a delight. The gentleman on the other end of the line was knowledgeable, he had a sense of humor, and was eager to help.” 

Jason is a delight to work with and is always willing to go above and beyond for a member. His commitment to member experience shows in the many ways he assists throughout the department and the positive member interactions he has. 

 

Response from Manager Kathy Boushon: 

Jason takes on the most difficult challenges without a second thought. All of 2024, he took care of a small group with access issues by being their concierge. He worked on every encounter, going above and beyond to make sure that all their questions were answered. There are many escalated complaints that he can help members resolve and understand the situation step by step. He is wonderful at problem-solving and able to help find numerous options for members. 

This was a comment from one of the members he assisted: 

• “I appreciate your continued efforts in resolving my billing issues with Apria. You were successful in assisting me along the year-long path. I don't know how I would have handled these issues without you and SHP. I thank you for keeping me informed along the way. I am extremely grateful!” 

Monica Morzinski – Security Health Plan

One of our employer-sponsored plans completed their Open Enrollment Period for the next plan year in March of 2024. It was a year when every employee needed to make an active enrollment. Their current plan would not roll over into the next plan year. Several notices went out from the employer to the employees reminding them that an active enrollment must be done.  

In late April 2024, an employee of that group contacted me, stating that her husband and children had been left off the plan during the enrollment period. She was sure that she had added them to the plan. She stated that she had been in contact with her Human Resources Department, and they advised her that since an active enrollment was needed and several notices had gone out, there was nothing that they would be able to do to add them to the plan without a special enrollment.  

I explored the possibility of putting her husband and both children on a plan through the health exchange. They were not offered a tax credit on the exchange, resulting in them having to pay full price for a plan. Their premium was going to be over $1,500 with a high deductible. They could not afford that plan. She was seriously considering looking for a different job since her husband and children needed health insurance.  

I advised her that I would contact our department manager to see if there was anything else we could do to get them on her plan. My manager responded that she was aware of some glitches that happened during the online enrollment for those employees. She stated to have the employee send an email to her manager, and they can send it on to the employer.  

After some consideration from the employer, she was able to add her husband and children back to her plan with a start date of April 1st. It was already May by this time, and there were several claims for her family that could not be processed since they were not on the plan. I called our claims department and had them reprocess the denied claims for the family. I then called each provider that we had claims for and advised that the eligibility had been straightened out and that we would be reprocessing the claims to apply to the policy benefits. I watched the account and let the employee know when all claims had been reprocessed. She thanked me for following the issue until its resolution.  

A few months later, during one of our department meetings, I was asked to go to the manager’s office who was running the online meeting. In her office was the Giving Officer for the employer. She explained to me that the employee had made a donation, through the employer, to a charity in my name. I would also be given a Shining Star award. The employee felt compelled to make a donation on my behalf. She appreciated my helping her through the process and wanted to make sure that I was recognized for going above and beyond. I was humbled to hear that I had made such an impact by doing what I believe is my job. To know her perception and appreciation for me assisting her through the issue leaves me satisfied with the work I do. It’s not that I do not get recognized for my work. However, when that recognition comes from a member directly and with such magnitude, it makes it just a bit more special.  

 

Background Written by Katie Johansson – Workforce Analyst:  

Monica Morzinski has been with Security Health Plan since October 2014. She has quickly become an integral part of our Customer Service team, wearing many different hats. She is trained on all product lines and is a licensed Benefit Specialist. She works across multiple different channels, including live calls, chat channels, and assisting walk-ups in person. Monica always has a willingness to help out and pick up any extra duties that need to be done. She isn’t afraid to take charge and consistently goes above and beyond for our members and staff throughout the health plan. Many coworkers from different departments reach out to her with complex benefit questions, and she is always willing to help with a smile. She is a wonderful team player and role model for our new agents, as she frequently has new agents sit in and listen to calls with her.  

Monica had an incredible year in 2024 on her SQM surveys. She was the only agent in our department who scored 100% across many of the main KPI’s. She received 100% for FCR, Call Resolution, CSR CSAT, and World Class. Compared to 2023, this was a 12% improvement in FCR, 4% improvement in Call Resolution, 4% improvement in CSR CSAT, and 4% improvement in World Class. She historically has always performed at a higher level, but she really outdid herself in 2024, making it her highest performing year.  

Monica consistently receives outstanding feedback on her surveys. Below are some of the comments received in 2024: 

• “Polite, helpful, patient, and outstanding in every way.” 

• “She was very helpful and polite. She answered all my questions and went over other things with my policy. She went above and beyond in her job.” 

• “She was very professional. She gave me the information I needed. Very accurate. Friendly. She was very good.” 

 

Response from Supervisor/Call Coach Tanalee Luedtke:  

Monica has consistently demonstrated exceptional Customer Service skills, going above and beyond to meet the needs of our members with professionalism and empathy. She is able to handle complex issues with grace, resolve issues efficiently, and ensure member satisfaction. Her dedication and outstanding performance make her a deserving candidate for Agent of the Year. I am extremely proud to have her on my team!  

 

Response from Manager Kathy Boushon:  

Monica is our Marketplace expert. She is very knowledgeable on the ins and outs of the plans and navigating eligibility corrections with the Marketplace. She is great with people and friendly with everyone. 

Wendi Anibas – Security Health Plan

I had an individual call in stating that she received ID cards and that she was enrolled into SHP EPO Silver Select Marketplace policy with a start date of July 1st. the member stated that she had only been on her spouse's work policy since Ocober through his employer, had not had a FFM policy, nor did she want an FFM policy. This policy had a $0 premium, as a tax credit was being applied to pay for the premium. 

She stated that she received a 1095A for the 2024 APTC in the amount of $542.70, and she could not file her taxes in 2024 because of this mess-up. I verified demographics, which were not correct. The address and phone number on file were her mom’s, and the email address on file was her spouse's. It was here that we were beginning to suspect possible fraud, waste, and abuse. We contacted our Enrollment department to verify who submitted her application and were provided with an unfamiliar agent name. 

We were then able to submit a HICS to the Marketplace for fraud, waste, and abuse, as the agent submitting the application was deemed fraudulent. The Marketplace was able to cancel her 2024 policy as if it had never been effective, cancelling it for fraud. 

Fraud, waste, and abuse are sometimes very easy to spot; however, something as simple as an incorrect address on a member's account could be a signal of something very wrong. The member and I were very happy to get this straightened out so that she is now able to file her 2024 taxes. 

 

Background Written by Katie Johansson – Workforce Analyst: 

Wendi Anibas has been with Security Health Plan since February 2016. She has been a great addition to our Customer Service team. She is trained on all product lines and is a licensed Benefit Specialist. She works across multiple channels, including live calls, chat channels, and our email process. We can always count on Wendi to be thorough and timely with her work. She is great about bringing up questions or concerns about whether the process could be done better or more efficiently. Listening to Wendi’s calls is like receiving a nice hug. She makes you feel well cared for and respected. She is an all-around wonderful agent and coworker. 

Wendi had a great year in 2024 on her SQM surveys, seeing many improvements across the board, finishing with one of the highest averages across the department. She had a 94% FCR, 98% Call Resolution, 98% CSR CSAT, and 98% World Class. This was an 8% increase in FCR, 6% increase in Call Resolution, 9% increase in CSR CSAT, and 12% increase in World Class. 

Wendi consistently receives outstanding feedback on her surveys. Below are some of the comments received in 2024: 

• “Wendi is excellent at her job and provided a positive customer experience!” 

• “She went out of her way to resolve my issue.  She was professional, friendly, and caring.” 

• “She answered my question and then helped me clear up questions on my husband's new plan. She was very helpful and did not make me feel rushed. Wendi did a wonderful job explaining things. I was happy to be able to talk to an informed real person.” 

 

Response from Call Coach Sarah Ford:  

Member Dylan advised: “I chatted with Wendi both times, and she answered all my questions and even contacted the facility I was having difficulty with regarding a claim. She did everything she could to help me. I had to chat a second time to follow up on a claim submission that was supposed to come from an ER visit. I had asked the healthcare facility to submit it three times, but I still had not seen anything in my patient portal. Wendi, whom I was privileged enough to chat with both times, even called the healthcare facility that I was having difficulty with to follow up and see if they had submitted the claim. She was amazing and so helpful!” 

Wendi Anibas is a fantastic employee who goes out of her way to make sure member issues are resolved. She strives to take the member out of the middle and not leave them with homework. That is why, in this case, when our member Dylan was having issues with claims being submitted to be paid, she reached out to the provider’s office so he did not have to. She made sure that the claims were going to be submitted and chatted with him again to confirm the information so he did not have to worry.  

Wendi strives for member experience, not only on the phone but also in the alternative contact channels we offer. Wendi is looking to the future, leading the department in customer service with chats, emails, and secure messages.  

She assists members with setting up their portal accounts.  

When trying to get into her member portal, member Elizabeth advised that Wendi was “Friendly, efficient, and very helpful. She was very easy to deal with in a timely manner, and my questions were answered.” Wendi was able to walk Elizabeth through the portal process and then got her benefit information as well. 

She always shows care and concern to members, regardless of what format she uses. 

Members Dorothy and Danny had questions on their plans. Wendi was able to help both of them. They advised about her: “She answered my question and then helped me clear up questions on my husband's new plan. She was very helpful and did not make me feel rushed. Wendi did a wonderful job explaining things. I was happy to be able to talk to an informed real person. Whenever we call, the representatives are helpful and informed, and if they don't know the answers, they find out. This is very important to have answers and information available – it eases the stress.” 

Wendi works closely with members, making sure their issues are resolved, and they do not have any homework. Member Margaret had been seen in the ER while she was out of network. Her ER provider needed her to see a retina specialist the next day. Out-of-network follow-ups require prior authorization. Wendi took control of the situation for the member, contacting the provider and the internal prior authorization team. She was able to get the prior authorization process moving. It was approved that day, and the member was notified that she should see her specialist the next day. Margaret was really happy with Wendi’s assistance. She writes that: “Wendi was absolutely amazing. She went above and beyond to untangle the pre-authorization issues, and she called me back at the end of the day when the issues were resolved. She was professional, personable, and kind. Excellent!” 

I love Wendi’s commitment to member experience. 

 

Response from Manager John Phillippi:  

Wendi’s score of 98% on her SQM surveys reflects her dedication to our members and that they appreciate her. 

Wendi’s willingness to go above and beyond for each of the members she interacts with is evident in the feedback she receives from the members. 

Wendi is also a great teammate and is willing to assist other agents when needed. She is a resource when complex situations come up. 

Andrea Kendall – VSP Vision Care

Feedback shared from her peers: 

• “Your kindness has not only made the challenging days easier but also created a positive and welcoming atmosphere in our workplace. I truly appreciate your generosity and the way you always go above and beyond to assist others. Thank you for being such a wonderful colleague. I am grateful to have you on our team and look forward to continuing to work together.” 

 

Feedback Shared from her Supervisor:  

Andrea started her journey with VSP in 2022 and has been an amazing employee since day one. She quickly understands the customer’s needs and flawlessly navigates the system to resolve their issue efficiently. Once she finished training, she excelled at helping the customers so quickly. This allowed her to move in to support her peers, which put her in a mentor role. She has always shown interest in mentoring others, and she is currently the go-to person on her team anytime assistance is needed. She not only helps her peers from a customer standpoint but also on a personal level. Anytime a peer may be having a bad day, she knows just what to say to cheer them up. When she is not in attendance at work, her presence is missed, and everyone notices. This goes to show how much of a valued employee and colleague she is to others. 

Anytime I provide her with any coaching feedback, she immediately implements it. She will follow up with me and always say, “Listen to this call and you will see I made improvements.” It feels good to have an employee who takes accountability for her actions and shows her commitment to growing each day. 

She does so well interacting with her customers and resolving their issues that they always want to leave feedback to speak about their experience with her. Here are a few impactful statements Andrea’s callers have made: 

• “My name is Colleen, and I just got off the phone with Andrea, and I wanted to let you know she was amazing. I could sense the smile on her face while she was talking to me, and that meant everything to me. So, I just wanted to let you know she deserves a hug and a pat on the back and probably a raise for this.” 

• “My name is Laurie, and I'm calling to say that Andrea took my call and was kind and very helpful and assisted me with a nightmare that I'm going through right now regarding a claim. I just wanted to call and say that we really appreciated her help.” 

• “She helped me with my vision issues and thoroughly explained everything to me. Give her a big raise and an extra couple of bucks a month or week. I am just teasing. I want to give her a shoutout and let you know that you are doing a great job with your employees." 

• “My name is Todd. I just spoke to Andrea, and I just wanted to say she did a great job and provided really great customer service. She was very knowledgeable and took care of my trouble. I just wanted to give her a pat on the back there.” 

These are just a few impactful statements from her customers, and she continues to receive positive feedback frequently. 

I wanted to share a special scenario that shows her commitment to going the extra mile to help a customer. In this scenario, Andrea had a difficult customer, and she went above and beyond to make sure their issue was resolved. The member called in looking for reimbursement for the glasses he purchased. Andrea did not see a reimbursement on the member’s account. She explained to the customer that she did not show that it was submitted, but would be happy to submit the claim for him and walk him through the steps of how to complete it moving forward. Andrea helped the member get registered on vsp.com, along with walking through the steps on how to submit a claim and view a claim that has been submitted. This call took about 45 minutes to get resolved, but Andrea showed patience, resilience, and engagement while interacting with the customer. This member left the following feedback for Andrea, "I'm a senior citizen who purchased a pair of glasses, and I put in for a reimbursement a while ago. Andrea was caring and patient. She walked me through the process of registering online, and I just want to say, "I applaud and give her kudos for such great customer service. She's very pleasant, she's very knowledgeable, and she was very patient with an old lady. Thank you for all that she does for your company. Let her know that she's very much appreciated.” 

Most of all, Andrea genuinely cares about the work she does each day to help her customers and her peers. I would love to have twenty Andrea’s on my team if that were possible. Her level of commitment is unmatched, and she would be the best choice for this award. 

Anna Marshall – VSP Vision Care

Feedback shared from her peers: 

• “I want to take a moment to express my sincere gratitude for all the support and assistance you’ve provided. Your help has made a significant difference in my work, and I truly appreciate your willingness to lend a hand whenever it is needed. Your positive attitude and teamwork have been incredibly motivating, and I feel fortunate to have you as a colleague. Thank you for being such a reliable and supportive co-worker.” 

 

Feedback Shared from her Supervisor: 

Anna has been a ray of sunshine since she joined VSP in 2023. There is never a day she logs into work, and you do not hear the smile in her voice. She treats her customers with care and takes it one call at a time. She encourages her peers throughout the day. If there is ever a time her peer needs assistance or is having a bad day, she knows the right things to say to open their heart and put a smile on their face. 

Anna is determined on every call to resolve the customer needs without them having to call back in with 100% focus on First Call Resolution. She follows up with the caller if there are ever any actions that need to be taken on her end or the caller’s end. She does not provide the callers with any homework and will stay late to make sure her customers’ issues are resolved. Her patience, warmth, authenticity, and passion keep her colleagues motivated because they want to perform as she does. 

She is a great role model for her peers. She always jumps in to answer any questions if they are stuck on a customer situation. She is our fun person on the team who always keeps everyone in positive spirits and interacting in the chat. Her motivation is what makes her driven, determined, and capable of achieving her goals. 

Because of her drive to always go the extra mile, her customers always leave feedback on their experience with her. Here are a few impactful statements Anna’s callers have made: 

• “Anna was perfect in every way. I especially liked that she was patient with me interrupting and asking a specific question. She was very nice about that. It was all perfect. Thank you very much.” 

• “Anna was very courteous, very easy to communicate with, took care of my needs in a satisfactory manner, and was very helpful.” 

• “She gave me the information that I needed, she got it very quickly, and I was very pleased with the call. I needed some information for income tax purposes. She helped me out a great deal. Thank you.” 

• “Speaking to Anna was one of the best customer service experiences I have ever had. The effort she put into resolving my issue was appreciated. I would speak to Anna every time I called VSP if I could.” 

There are so many of these statements in which Anna went the extra mile to resolve the caller's needs. 

Here is an example of Anna going the extra mile to resolve a difficult customer issue: The member called in very upset due to being transferred multiple times. Not only that, but the member had also been provided with misinformation through multiple interactions with other customer service reps. The member wanted to know their benefit coverage for going out of network. Anna took the time to first empathize with the member regarding their experience so far, confirmed she understood exactly what they needed, and efficiently provided the member with the correct information regarding their plan. The member expressed frustration with how long they had been on the phone, and Anna made sure she quickly worked to provide the member with what they needed. At the end of the call, the member apologized to Anna for taking their frustrations out on her and wanted to share their satisfaction by leaving feedback. 

• "She was fantastic in assisting me today. Her customer service skills are impeccable. She is kind and patient and went out of her way to explain things to me, and I cannot thank you guys enough. She deserves kudos. I will not only continue doing business with you guys forever as long as that's humanly possible, but I also plan to tell all of my family and friends if they don't have the VSP that they should get it." 

Anna understands what providing World Class Service really means. Anna’s efforts and commitment to helping her customers are why she is a ray of sunshine in my eyes. She positively impacts her customers, peers, and other team members. For that reason alone, she deserves this award.

Cristal Gonzales – VSP Vision Care

Cristal’s consistency was evident when tracking her monthly stats in SQM surveys. In all months except for one, she had 100% Call Resolved and Caller Satisfaction (CSAT) for 2024! Cristal is sometimes quiet in a team setting, but you wouldn’t know this when listening to her provide great service on her calls. She also took an opportunity to help in another department of the business. She did the same amazing job over there and learned more things to help her provide even better service in her regular job duties. 

Here is one of the customer compliments that has been received on Cristal: 

• “Hello, my name is Gregory. I'm calling in regard to Cristal, whom I have just spent almost the last hour with. She has been extremely insightful, helpful, friendly, courteous, and patient with me and has answered an enormous number of questions that I've had. She's got me back on the right track, and I would have been in a load of trouble without her. You have a great employee on your hands. She’s exemplary. I just want to make sure she gets the credit she deserves. Again, Cristal is a wonderful asset to your team.” 

In addition to the story above, here are some of the other comments callers have left on Cristal: 

• “I am leaving a message to let you know that Cristal is a wonderful worker, and she just walked me through all the steps that I needed.” 

• “I want you to know that she was very pleasant and very professional. She was on the mark, and I greatly appreciated her help. I want to give her kudos and accolades, and she did her job in a very efficient, exceptional way.” 

• “I wanted to give Cristal a review. She did an outstanding job. I am very pleased with her knowledge. She took time to break down costs. You have a very good person there, and I think she should be recognized for her hard work.” 

I hope Cristal is recognized for excellent customer service; it really makes a difference.

Maureen Steele – VSP Vision Care

Building rapport is a key part of excellent customer service, and this is one area where Maureen excels. Her ability to add a little humor or share a small anecdote really helps to create a friendly atmosphere, making interactions more enjoyable and personal. That kind of connection not only makes callers feel more at ease but also leaves a lasting positive impression. 

Maureen consistently receives glowing reviews from satisfied callers. Her ability to build genuine connections creates a memorable experience that leaves callers feeling heard and appreciated. It’s clear she has mastered the art of making service feel both personal and entertaining, while remaining professional. It’s a great testament to her skill and commitment to excellent service. 

Here's one example of a glowing Proud Letter review she received from a member: 

• “Maureen has been fantastic, absolutely the best customer service, and a fantastic person. I cannot express how satisfied I am with speaking with her and how much she helped me put my mind at ease. She answered every question that I had. I absolutely think that you need 100 more employees just like her, but I just wanted to say thank you for having an employee like that to be able to take care of me. Thank you so much, and I hope that she gets all the praise and accolades that she deserves in the coming years because I imagine she takes care of everyone the same way she took care of me. Thank you again for having an employee like her, and I just can't say enough nice things about her.” 

Here is a Proud Letter she received from a member who was so happy she’ll be able to keep her VSP coverage in the future: 

• “I just got off the phone with Maureen, and I just wanted to commend her. She is really professional and answered all the questions I had regarding my plan. I was considering switching from Premier to Basic since my employer pays for that, but after talking to Maureen, I'm going to stick with Premier. Maureen was good at answering the questions I had. I turn 65 next year, and I wanted to see if I can keep VSP as my plan, and it looks like I can! I like pointing out people who are doing things right, and I just wanted to let you know that Maureen is a class act. I hope I'll get her the next time I call.” 

As highlighted in these examples, Maureen’s interactions consistently go beyond just resolving issues; they create a memorable experience that builds lasting brand loyalty. On behalf of all the grateful members lucky enough to have been assisted by Maureen when they called, I’m nominating her to be the CSR of the Year.