2015 Agent – Great Customer Service Stories

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Remained in Control of the Call

“Troy transformed from a mere Customer Service Representative, to the ideal member advocate and provider of care.”

Troy began his tenure with AmeriHealth Caritas in April 2015, and has been the model employee since day one, including the achievement of perfect attendance for his entire tenure. From my first interaction with Troy to this present time, he has always stressed the importance of customer satisfaction in every interaction. Troy has a dedication to empathizing with and resolving any inquiries presented by a member, and will go above and beyond to remove barriers that may be preventing the member from receiving the care they so desperately need and deserve. Troy’s consistently exceptional quality scores, positive customer feedback, and World Class Survey results are key indicators in determining his level of commitment as a Customer Service Representative. Customer Service can be challenge in any arena, but specifically when attempting to meet the healthcare needs of an underprivileged and under-served population. Troy has risen to this challenge, and has taken advantage of every call as an opportunity to positively impact our member’s lives and overall well-being.

One call in particular where this was demonstrated, pertained to an extremely irate and difficult member who called into our Contact Center. The member was ill and had faced challenges in the past with receiving her prescribed medication. By the time the member reached Troy, she was at the point of distress and was less than pleased with the service she had received thus far. Call monitoring is a standard part of our coaching program, and as Troy’s Supervisor I just so happened to be silently monitoring this call from my desk. I was able to hear how uncooperative and verbally abusive the caller was towards Troy, and immediately walked over to provide him with some additional support. However, I was in for a pleasant surprise as I approached Troy’s desk! The average Customer Service Representative would be upset and visibly shaken after being berated over the telephone for several minutes. Troy on the other hand was calm, remained in control of the call, and was still very much committed to assisting the caller despite her demeanor. I watched as Troy utilized intuitive listening and consummate soft skills to de-escalate the matter, while also winning the member over through his confidence that he could achieve a positive resolution to her issue. During this call, Troy transformed from a mere Customer Service Representative, to the ideal member advocate and provider of care. He remained engaged and dedicated to this caller, even when her issues went far beyond his scope of influence. Troy would have been well within his right to simply transfer the caller to our Pharmacy department, but instead chose to speak to the Pharmacy department on the member’s behalf to ensure that the member received the medication that was needed and didn’t encounter any further inconveniences. By the end of the call the member that was dissatisfied with our company and all of the Customer Service Representatives she spoke to previously, was overjoyed with Troy’s service. Troy uses that same level of compassion and dedication on all of his calls, which is why he is more than deserving of the CSR of the Year award.

Troy Hammond Little – AmeriHealth Caritas

 

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Life-Changing Customer Service

“Thanks to Dan’s exceptional customer service skills and commitment to what he does, this member does not have to worry about anything else.”

I believe that most Customer Service Representatives don’t fully realize the impact they have on the lives of others. Customer Service Representatives are the listening ear and the helping hand. They provide the information, the guidance and the caring support that change the lives of their customers. Working in the Health Care Industry, I have the honor of witnessing the impact that my team of Customer Service Representatives have on the lives of our members on a daily basis.

The backdrop to an amazing customer service story that I would like to share is framed by a sad reality we are facing today. Chances are each of you has heard about our country’s escalating opioid addiction crisis. The opioid crisis is impacting families and communities across all socioeconomic groups and leaving many destroyed lives in its wake. Because of the industry I work in, my team of Customer Service Representatives assists many members who have been personally touched by this growing epidemic. It is in this context that Daniel Peters was able to provide a life-changing customer service experience to one of our members who had been impacted by opioid addiction. Dan realized as soon as the call came in that on the other end of the line was a member who needed help. The member sounded frantic and there was a lot of fear and anxiety in her voice. Dan paid close attention to everything the member was saying in order to completely understand the bits and pieces of information she was providing to him. By deploying a caring and calm tone, and by asking the correct questions, Dan was able to get the full picture of the member’s issue.

Our member had been in the middle of her opioid addiction treatment when, as life would have it, unforeseen circumstances forced her to move to another state. As if moving to a different state mid-treatment was not bad enough, there were no clinics or doctors close to the member’s new residence that would accept her insurance. The member had found a clinic that could provide the treatment she needed, but they would not accept her insurance, and had asked for payment up front. The member was not only worried because there was a possibility that she would not be able to complete the treatment she so desperately needed but, now in addition, she had to decide between her treatment and, without insurance coverage, the ability to put food on the table for her children. Dan was profoundly moved by the member’s predicament and did not need to hear anything else. Dan was committed to becoming this member’s advocate and on not giving up until he was able to resolve the issue at hand.

Resolving the issue at hand would not be easy so Dan didn’t waste any time. He knew that this was not an issue that would be solved with one phone call while the member waited on hold. Dan started working the problem by contacting his manager. After explaining the situation, Dan requested the approval for the additional time commitment it would require to resolve the situation. With his manager’s full support, Dan explained to the member that he would work on her issue and call her back with an update shortly, and that he would continue to do it until everything was resolved. The member sounded relieved but still uncertain before disconnecting. Dan knew he would have to gain the member’s trust with quick hard work!

Because there were so many steps that needed to be completed, after the member disconnected, Dan started by contacting the clinic where the member was going for her treatment. Dan explained to the clinic that an authorization was required and walked the provider through the steps of getting the correct form, filling it out and faxing it to the correct department. At the end of the first day, Dan contacted the member to advise her of what he had accomplished and what he was planning to do on the next day. The member shared that she was happy and surprised to hear back from him on the same day.

On the next day, as soon as he received the authorization paperwork from the clinic, Dan worked with an internal department to get it escalated as a priority. By mid-day Dan found out that additional information was necessary and he called the out-of-state clinic one more time to get the required documents. At the end of the second day, Dan called the member to advise what had happened and that he had already received the additional paperwork. He explained he just needed to allow the authorization department to complete the review of the request. By Dan’s second follow-up call, the member’s tone had changed. Dan had gained her trust! This member knew Dan would be doing everything he could do to help her.

Dan called the member again on the third day. This time, Dan was happy to advise the member that the authorization had been approved. Upon approval, the clinic had come to agree to submit the claim to the insurance on the member’s behalf, and would not be asking the member to pay for the services up front out of pocket. Upon hearing this news from Dan, our member could no longer contain her tears, but this time they were happy tears. The member proceeded to tell Dan that she had never had anyone help her like he did and that she was now looking forward to kicking her addition and to the wonderful drug-free life ahead of her.

In sharing this story, I am hoping to convey that Customer Service Representatives can change lives! Thanks to Dan’s exceptional customer service skills and commitment to what he does, this member does not have to worry about anything else but her recovery.

Thanks Dan for always providing this level of customer service to every member you come in contact with. Customer Service Representatives like you make me proud to say that I am a Customer Service Manager.

Daniel Peters – Blue Cross Blue Shield of Massachusetts

 

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The Service They Deserve

“Each call that Alex takes is a story of how she exceeds the customer’s expectations.”

Customer Service has evolved over the past decade for the betterment of our customers. In years past, customer service was focused on the number of calls; the shift is now on resolving customer issues. Alex has been with BlueCross BlueShield of South Carolina for over 13 years and all in Customer Service. She truly loves what she does and it shows. She has embraced the changes in customer service and evolved with the times. At one time she took a high number of calls. Now she is a world class advocate.

This is Alex’s third consecutive year as a world class advocate, as designated by SQM. Every day, Alex goes above and beyond for our members, so each call that Alex takes is a story of how she exceeds the customer’s expectations. Customers ask for Alex when they call, knowing their issue will be resolved and they will get the service they deserve. When not on the phone, Alex coaches other advocates and assists with their inquiries.

The below is a typical example of how Alex goes above and beyond for her members:

On one of the last days of the year in 2015, Alex received a call from a member who was wheelchair-bound. The member lived in New York City and could not get around the city without a mechanical scooter. The member stated to Alex that she had a scooter but it became inoperable the previous month and she has not been able to leave her apartment since. The subway was over two blocks away so the member had been a “shut-in” for over a month. This left her unable to make her doctor appointments and visit family over the holiday. She stated that because of not being able to leave her apartment, she had not been able to go and get a replacement scooter. The member had satisfied her deductible in 2015; however, since 2016 was less than a day or two away, she stated she would not be able to afford to get the scooter.

Alex took this as a challenge to get the member’s issue taken care of that day. With a short window of time Alex began calling all in-network providers in the area. After over 10 calls to multiple providers, she found a provider that was willing to not only file the claim that day, but deliver the scooter to the member the next day. Alex’s work was still not done at this point; she then had to ensure the precertification was authorized since the process was not started. Alex was able to accomplish all of this in less than 24 hours so the member could get around the city. The member personally thanked Alex, saying that no one had ever taken the time to treat her like a person and go the extra mile.

Alex Beeks – Blue Cross and Blue Shield of South Carolina

 

 

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A Last-Ditch Effort to Resolve the Issue

“The member had turned to us in his time of need and Amir took ownership of the issue.”

Customer service consistently presents some challenges for the people who serve on the front lines every day. Our customer service advocates are tasked with not only being the face and voice of our company, but the subject matter expert as well. In addition to knowing all of the business rules and policies, our advocates need to be well versed in acknowledgement and de-escalation skills to help diffuse the often emotional calls that come in. It takes a special person to embrace the unexpected and diligently work to resolve the caller’s issue in the face of adversity. Amir Shokoohi is one of those special people. Amir is the epitome of a world class advocate. Patient, empathetic, and laborious are three of the first words that come to mind when thinking of Amir. On a day in February, Amir put all of these skills into play when resolving an issue that was escalated to the CEO of our company from an extremely dissatisfied member.

The introduction of the Affordable Care Act Plan saw a new level of governmental oversight projected into the health insurance industry. This has placed limitations on actions that customer service advocates could take to resolve issues. Recently, one of our members found himself in a situation that was created by the new limitations. Back in February, Amir was tasked with reaching out to a member who had contacted the CEO of our company. The member was extremely frustrated and had given up any hope of receiving the assistance that he needed from our customer service advocates. He saw his only option as voicing his complaint to the CEO in a last-ditch effort to resolve the issue. The root cause of the member’s issue was a policy cancellation that was caused by the nonpayment of health insurance premiums. The member was having a difficult time keeping up with the insurance payments. He was making payments to the best of his ability, but unfortunately this eventually caused his policy to cancel. The main issue with this was the member was adamant that he had made all of his payments that he was billed for. This caused him to be extremely upset and resulted in numerous calls into our department. He needed a prescription and could not pick it up because the policy was cancelled. When our member felt like he had no other options because, in his opinion, no one was willing to help him, he sought assistance from our CEO.

Upon receipt of the member’s complaint, our CEO brought the operations team into the issue. Amir was asked to research the issue and see what was going on. As soon as Amir was given this assignment, he immediately prioritized the issue because it was clear that the member’s needs were not being met. Through his careful review, Amir was able to create a detailed timeline of the payment history of the member’s account. The allowed him to determine the viable solutions with the options the member had available to him.

Armed with the account audit results and available options for the member, Amir then reached out to the member. Amir spent a significant amount of time just listening to the member. He wanted the member to know that he was being heard and that he truly mattered to the team. Until the call with Amir, the member had not had his emotion or issue truly acknowledged. By making sure the member knew he was being heard, Amir created an atmosphere in which the member was now ready to listen. Amir went through every piece of the payment history. He provided specific dates and times those payments processed. By going through this with such attention to detail, Amir helped the member realize that he did not make a payment as he thought he did. Once the member came to this realization, Amir began to discuss how the member could reinstate his coverage. By reinstating the coverage, the member would then be able to secure his prescription that he needed. As Amir explained to the member how much of a payment was needed in order to activate the coverage, this brought another dimension to the problem at hand. The member began to talk in detail about how he recently had a significant decrease in his income. He was going through severe financial distress and did not have the money to make the payment at the time. Amir, once again, listened and acknowledged how problematic that this was for the member Amir asked the member if he could do some additional research and call him back. While he was at first hesitant, the member agreed. Once off the call, Amir sought the approval of his management staff to allow an exception in regard to the payment due requirement. While it is standard operation procedure to require full payment at the time of reinstatement, Amir advocated on behalf of this member. He put forth the notion that this man was in need of his medication and his current financial situation was created through no fault of his own. He had become a victim of circumstance and this would be an opportunity for us to give him a break. Amir was able to compel the management staff to make an exception. Amir immediately called the member back because he knew that this issue would continue to weigh heavily on the member’s mind until there was a resolution. Amir advised the member that he had gotten approval to allow the policy to be reinstated with a verbal commitment to make full payment the following Monday. The member was elated! He was more than willing to make the payment – he just needed a couple more days. While they were still on the phone, Amir was able to have both the medical and prescription coverage reinstated. He reached out to the member’s pharmacy and had the prescription reprocessed. Amir confirmed the correct copayment amount for the medication. He brought the member back on the line and told him his medication was ready for pick up. He was also able to let the member know how much it would cost. The member could not thank Amir enough. Amir had advocated for this member when he needed it the most.

While this was the solution to the member’s immediate issue, Amir had come to the realization that there was a bigger issue at hand. Through his active listening, Amir was also able to anticipate that if this member did not look into a more cost-effective plan he would likely find himself in a similar situation in the future. This was not an option for Amir. He wanted to ensure this member not only had access to insurance but he wanted to make sure the member would not have to encounter this type of situation again if at all possible.

Amir explained to the member that he wanted to facilitate a phone call with the Federal Marketplace in order to ensure that the correct income amount for his household was on file. By confirming the income amount on file, Amir can ensure that the member had access to all of the assistance he was entitled to. The member was more than appreciative because he did not realize this was an option to him. He was impressed that Amir would even take the time to think about something like this for him. After spending a great deal of time on the phone with the member and the Federal Marketplace, Amir had confirmed that there was an error with the amount of household income the member had on file. This had caused the member to have to pay more per month for his premium and his cost share on the insurance plan. Through his attention to detail and active listening, Amir was successfully able to assist the member in enrolling in another one of our plans that allowed him to take advantage of all of the assistance he was now entitled to since his income decrease.

To say that the member was thankful would be an extreme understatement. He was overjoyed! In fact, the same member who lodged a complaint with our CEO sent a glowing letter of appreciation back to the CEO to explain that he was impressed with the level of service and professionalism that Amir had provided to him. His view of our insurance company was completely changed because of the actions of Amir. Amir took the time to make sure the member knew he was heard and that he mattered and that he truly mattered and was not just a number. Amir recognized that there was a person on the other end of the phone and he had feelings. The member had turned to us in his time of need and Amir took ownership of the issue and worked until the member’s immediate and long terms needs were handled.

Too often people seek to resolve the immediate issue at hand and do not take the time to look forward and anticipate future needs. It is this type of forward thinking that will prove to be the world class service that all companies strive to provide. Amir Shokoohi has proven countless times that he always seeks to take ownership of the issue at hand and work diligently until it is resolved. He is a true asset to our members, team, and company as a whole!

Amir Shokoohi – Blue Cross and Blue Shield of South Carolina

 

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Focused On Resolving the Issue Permanently

“Now claims are being paid to providers for not only this member, but for all members in this circumstance.”

Sometimes all it takes to resolve a call is asking yourself “What is the rest of the story?” Such was the case with this call. I received a call from a member, frustrated and angry that she was STILL having issues with getting her HRA to pay for her services directly. I could see that she had called previously and she was sick of trying to track down payments and confused as to why the process wasn’t working the way she and I both believed it should be. I knew there had to be an underlying issue that was causing this to happen over and over that there was “more to the story.” I assured her I would not only reach out to the HRA Company on her behalf to confirm the status of these payments, but would also work to determine what was causing this issue and correct it for future services.

For this plan, BlueCross BlueShield of Vermont had set up a file feed with her HRA Company to automatically send claims processing data to them. The HRA account could then pay her providers directly for any cost shares covered by the HRA, such as deductible. Normally, the HRA Company receives the provider’s mailing information from our claims data feed, however, with providers outside our area the process is a little different. In this case, the file feed would indicate the Provider is “Out of State,” and the HRA Company’s system would then check a different area of the file for the Out of State provider’s address.

I knew from the wife’s frustration that she really didn’t understand what was happening, since she kept being told by the HRA Company that payments were made and cashed, but she was still getting bills from some of her providers.

By working with both an internal contact, and with the HRA Company, we were able to determine that the HRA Company’s system was reading “Out of State” in the address section as equaling “no address available,” and setting up the claims to pay the member instead of checking for the address in the correct section of the file. This was the root cause of the member’s issue. She was receiving bills from the provider and having to call the HRA Company to find out where the payments were. During those calls, they would advise payments had been cashed, but when she called her provider he had no record of them. With this additional level of detail, we determined that the payments would go to her husband from the HRA Company because he was the policy holder, and he was cashing or depositing these payments. Then she would receive a bill and have no knowledge of receiving the checks. I was able to work with the HRA Company to determine what dates of service were paid by them, who they were paid to, as well as if they had been cashed. Then I was able to tell the wife what checks went to her husband and for what dates, so they could pay the provider for those dates.

Meanwhile, I was also working with our internal contact for the HRA Company to determine how to resolve this for the future. After we determined the cause was with the way the HRA company processed the Out of State provider claims, our internal contact worked out a process with the HRA company to work all the out of state providers’ claims manually, until the system was corrected to automatically look for the address the way it was supposed to.

Throughout this process, I was continuously keeping the member up to date at each point in the process, as well as monitoring the member’s account for claims from out of state providers, so I could be sure the claims would be manually worked until the feed processing issues were corrected. I am happy to report that the file processing was corrected, and now claims are being paid to providers for not only this member, but for all members in this circumstance, regardless of the provider’s location. I am also glad to have been able to work with others, both at BCBSVT as well as the HRA company, who were also focused on resolving the issue permanently. The member was glad I was able to take ownership of the issue and get it permanently resolved, and I’m thankful I was able to see this member through to the end and to prevent this issue from happening to other members in the future.

Amanda Emerson – BlueCross BlueShield of Vermont

 

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You Changed My Son’s Life

“You encouraged us to tell our story.”

It was a typical day in the call center until I got a call transferred to me. It was a member that I had previously assisted. Thinking back to that call, I had considered it just a typical call, educating a customer on their benefits and rights. That is what we do. That was until I got this call and the member says, “you changed my son’s life”. It was then I realized it’s not always the difficult cases that we can make the biggest difference to our customers, but sometimes the calls we think are easy, remind us that our knowledge in what we do, and what we share, can change a person’s life. That’s the story I want to share.

I received a call from a Dad, calling about his young son with a hearing impairment. He was asking why we weren’t paying his son’s speech therapy claims. I researched the claims we had on file and let him know that we didn’t have any claims on file for speech therapy. I reassured him that I would outreach to the speech therapist on his behalf and ask that they submit the claims. When talking to the therapist she explained that she hadn’t submitted any of the claims because she knows it’s something that’s not covered by insurance as it falls under “developmental delays”, a service the schools provide. As we discussed the claims, the therapist shared that she felt that speech therapy for hearing loss should not fall into this category as the child’s speech therapy was for hearing loss, not for developmental delays, and that schools don’t have enough support for children with hearing loss in Vermont. They are not getting the help and education they need in this area.

I have a friend who just went through this with her own hearing impaired son and she had to move out of state to get him a proper education, so I understood what she and the family were going through. I requested that the therapist send all the claims into us, allow them to deny, as this would give the family the opportunity to file an appeal and will allow them to tell their personal story. I also advised her that she can request a benefit exception, asking the Plan to review future visits for eligibility.

I then called the family back, explained my conversation with the provider, and advised what the next steps would be in the process. I explained that when they filed the appeal, they would want to be specific on their personal struggles and the lack of support for the deaf community in Vermont schools. I advised to include how they felt that his speech therapy is for hearing loss and shouldn’t be viewed as a developmental delay, but instead eligible under his medical benefits. The family thanked me for my help and said they were glad I could relate to what they were going through and at that time, I thought that was the last I would hear from them.

When they called me and said, “We just wanted to call you and thank you for what you did for our family. You encouraged us to tell our story, because of you we were not only approved for 30 speech therapy visits this year but BlueCross BlueShield of Vermont has allowed his claims from last year too. We are so grateful for your knowledge and understanding of what we were faced with. We feel so fortunate that we got you on the phone that day, you changed our son’s life.” The member then requested to speak to my supervisor and told her that she “was amazed to call an insurance company and speak to a representative that she felt really cared about her family, and was on their side.” This compliment actually brought tears to my eyes. By putting myself in my customer’s shoes, showing empathy, sharing knowledge, and clearly explaining their options, I had made a positive difference in this family’s life and this was a great reminder of the importance of the work that we do.

Amy Duhamel – BlueCross BlueShield of Vermont

 

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Walking in My Member’s Shoes

“I provided resolution to a very stressful situation and showed her that we are on her side.”

When I take a call, I don’t define myself as a Senior Member Service Representative. I’m an important part of a heartfelt team which sees our members through to the end. I believe in taking ownership of each call by walking in my member’s shoes. For those few moments, I become my member. Treat them as I long to be treated. Provide empathy, respect, sincerity, and understanding. I strive to be their “Wow moment.”

Recently, I received a call from a member who was extremely upset. I could hear the panic and frustration in her voice. She had called her doctor’s office to ensure everything was set for her test the following day. During that call the radiology department told her that they couldn’t authorize the test because her payment was pending with BlueCross BlueShield of Vermont.

The member panicked and called Vermont Health Connect, our State’s exchange, responsible for this member’s premium payment and reconciliation. This call resulted in a lengthy conversation which intensified her anxiety, frustration and pain level. She’d experienced an ongoing issue with Vermont Health Connects billing system. An erroneous posting error caused her premium invoices to reflect a premium credit in error. She would call Vermont Health Connect monthly to validate her balance due; however, because the system didn’t reflect a balance due it wouldn't allow her to make a payment.

Eventually the misapplied payment posted and the invoicing credit was corrected. She now showed a balance due which put her into a 30-day grace period for lack of payment. That day she made the payment by phone and was merely waiting for the payment to post and the hold to be removed from her account.

The member was scheduled that next day for an MRI procedure. She had been in severe pain for months and had waited since June for this test that would help identify the reason for her intense pain. Now she was being told it couldn’t be authorized due to this premium issue. It was the last straw. When she called BlueCross BlueShield of Vermont, I could hear the tears welling up, the catch in her voice. You could tell she was uncomfortable and felt hopeless.

With empathy, I stepped into her shoes and took control. I reassured her that I would definitely review her account, validate why they are unable to obtain an approval and search for resolution. I placed her on a brief hold and validated that she was only in a 30-day grace period. There was no foreseeable reason why the service couldn’t be authorized. The grace period had no bearing on why an authorization was unattainable and no need for her appointment to be cancelled.

I pulled the member back onto the call and clarified who she had spoken with. She gave me the number and pre-registration contact from the hospital. I took my member out of the middle by placing her back on another brief hold, calling the hospital on her behalf, and validating what the issue was.

Upon review, I discovered they had obtained approval for the MRI but were confused when they tried to confirm the member’s benefits online and the website indicated they were in a grace period and a payment was pending. The provider assumed this meant the member was in a 60-day grace period and claims and services would suspend and reject.

I explained to the provider that the member was only in a 30-day grace period. I advised we will not suspend claims or benefits. I explained that there was a billing error with Vermont Health Connect which was in the process of being resolved. I confirmed the member had active coverage for this appointment, she should not be turned away, and the appointment should not be cancelled. With that understanding, the provider quickly rescheduled the appointment for the MRI. I pulled my member back on the line and gave her the good news.

My compassionate level of concierge service consoled and eased the member’s mind. Her feedback was that I acted quickly, was empathetic and sympathetic to her plight. I provided resolution to a very stressful situation and showed her that we are on her side. We do see our members through.

Terry Kelty – BlueCross BlueShield of Vermont

 

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Quality of Care

“Her efforts have made a lasting impact with each Member that she engages with.”

Samantha "Sam" Cook is one of our top performers here at CareFirst BlueCross BlueShield in our Large Group Member Service SBU. She is a Primary Representative for one of our most innovative and flourishing programs called Total Care Cost Improvement (TCCI)/ Primary Center Medical Home (PCMH.) She serviced nearly 5000 Patient Center Medical Home calls in 2015 and provided the best of quality to our Local Care Coordinators and our most fragile Members; who are on care plans and working collaboratively in pursuit to improve their overall health. She additionally helped us to successfully co-pilot a Coram Site of Care outreach in July of 2015. In this pilot Sam proactively reached out to hundreds of our most ill members in order to offer them more convenient service, more convenient site of care settings, and all at a lower cost to both the members and CareFirst.

Her efforts have made a lasting impact with each Member that she engages with and those sentiments are echoed time and time again for her customers. In 2015 alone, she has received many kudos calls, internal accolades, received gold incentive monthly, was promoted to CSR II, was nominated as a monthly Rising Star, and has received multiple Service Excellence awards. She exceeded our internal Call Resolution goal in each month of 2015 and finished the year as one of our highest scoring associates out of 300 peers. She is dependable, she is a role model, a she is a dedicated associate; and more importantly she is truly changing lives on a daily basis. Below you will find just one example of the excellent customer service that she is providing daily in a letter received from a CareFirst Member that she worked with.

The member explained a critical point in her health care in which services were denied at the point-of-sale. This happens all too often to patients and they don’t often know where to turn for assistance and the education needed; luckily, our member did. She turned to Samantha. In our members weakened state, she could have potentially taken a turn for the worse without her multiple blood pressure medications. Samantha, in helping this member remove the barrier for care in this instance; truly aided her overall progress and helped to achieve the goals of her coordinated health care plan. There is nothing more rewarding to Samantha and to CareFirst than a winning outcome like this, one that ultimately helps reduce cost and increases quality of care.

Samantha Cook – CareFirst BlueCross BlueShield

 

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Family Reunion in Hawaii

“I gave her all the details, she was so excited and happy, and she cried and screamed.”

I have been with LoyaltyOne for 19 years and I have made some incredible memories with our collectors. Being in the customer service world, we have so many different personalities to deal with and we need to adapt to them. We need to be listeners, advisors, and most off all we need to be compassionate. The key to my success is to be very patient, to listen attentively, and to make the customer feel like you care about them.

One incident that really stands out to me was last February. I was working on a very busy Saturday, counting down the hours to the weekend. I took a call and was greeted by a very upset young mother; I could barely understand her because she was crying. I quickly took control of the call and asked her to calm down, and I would try my best to help her. She immediately calmed down and began to tell me her sad story. She was travelling from Grand Prairie to Hawaii with her husband and 2 small children, meeting with her parents and siblings for a family reunion in Hawaii. She drove from Grand Prairie to Calgary and her flight was from Calgary to Hawaii. The issue was the name on her ticket did not match her passport. Her passport was in her maiden name and the ticket was in her married name. This caused a huge ordeal. The airline would not allow her to check in. In order to make a name correction they needed proof of her marriage certificate but she now was in Calgary, 5 hours away from her home. I felt terrible and sad for her and her family, as I too have a young family and I could only imagine the disappointment and stress she felt at that moment. The collector felt so guilty and thoughtless for making such a terrible mistake. I reassured her that we all make mistakes and I would do my best to help find a solution. I put her on hold feeling a bit helpless because really there wasn’t anything I could have done without getting documentation from her, which was virtually impossible. I reviewed the ticket she was travelling on and suddenly I realized her flight was connecting via Vancouver and it was delayed more than 2 hours. My heart was pounding because this meant she could cancel her flight and get a full refund! My plan was to find her new flight options. I quickly checked for availability and found her new flights going out the next day and to her luck, we now had a special on the flights, which reduced the number of miles and taxes that she had originally paid. I gave her all the details, she was so excited and happy, and she cried and screamed. I think that everyone at the Calgary airport could hear her! I was so happy and emotional that I even shed a few tears! I felt so happy that I was able to help her with this difficult situation and get her to her family reunion. She was grateful, thankful and appreciative that I took the time and effort to find a solution to her problem. She was so impressed with my service and that she would never forget this positive experience she had dealing with Air Miles and me. I made her laugh by saying you have a great story to tell your family. How ironic that I am now sharing her story with all of you.

Enza Pitruzzella – LoyaltyOne

 

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The Last Christmas With His Father

“Creating a positive memorable customer experience resulting in a fundamental difference in the life of the customer.”

The customer called to change a flight booking he made online with Air Canada in October for a Christmas family re-union in Kelowna.

His father suddenly took ill and was given just a few days to live a week before his scheduled departure date. It had been a couple of years since he had seen his father and five siblings. Realizing heartbreakingly, that this would the last Christmas with his father, he felt it was imperative to leave as quickly as possible to spend whatever time he could with his whole family, and was willing to make the changes required at any cost.

As I was listening to the customer speaking, memories of my mum’s death flooded my mind. My youngest brother could not get a flight out of the UK during Christmas to attend mum’s funeral. Until today, this is still his biggest regret, and it took him a very long time to get closure. I felt his anticipatory grief leading to the ultimate loss of his father. At this point, I knew it was absolutely essential to fulfil his request as the impact and regrets would last forever if he was unable to see and be with his father one last time.

While accessing the details of his ticket, my immediate response was to empathize and reassure him that we would find a solution. At first glance, I knew the situation was far more challenging than I thought, given that he was from Edmonton where inclement weather was an issue. Additionally, it was the busiest time of the year with limited flight availability. After several attempts to book a flight with no success, I realized an immediate resolution was impossible. I offered to call him back in 2-3 hours, as I did not have the heart to add any more bad news to his already trying day. I confirmed preferred dates for travel, timing, flexibility, stop overs and routing. Taking ownership, I reassured him once again that I would do my utmost to get him a flight. Feeling desolate and defeated, he allowed me to use my discretion to do whatever was necessary to get to Kelowna.

Empowered and determined to find a flight for him, I mapped out all the possible routes, called Air Canada several times and even went as far as searching for a new ticket with another airline. All these attempts failed, yet I was unwilling to give up. Using all my experience, knowledge and tools, I got creative with the routing. It would require him to change airplanes in Calgary and Vancouver to get to Kelowna in time. After confirming flight times and requirements, I was elated that I had a resolution. Keeping my promise to him, I called him back and shared the wonderful news. He was overwhelmed and full of gratitude.

After the call, he left a message and said, “Nazreen was simply outstanding. She was compassionate, kind and absolutely provided remarkable customer service. Thank you.”

Assisting him made me realize that all calls allow us to make personal emotional connections, and sometimes, the ability to do something so profound it stays forever. This journey was a defining moment in his life and being part of it with LoyaltyOne was a privilege and honor.

Nazreen Abdulla – LoyaltyOne

 

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The Little Girl Only Agreed to Wear Pink

“The customer was thrilled and I held on the line, waiting to see if this little girl (less than an 8th of my age) would accept my offer.”

I had been at Marchon eyewear for just a month when my most memorable customer service experience occurred. I received a call from an eye doctor's office stating they had a young patient and her mother in their waiting room. The account let me know that the patient was very young with a high prescription and was wearing glasses for the first time. She was also VERY active. So active in fact that she had broken and replaced two pairs of glasses in the short time since she had started wearing them. The customer seemed frustrated and reiterated that every time the little girl left her office the glasses were fitted perfectly to her face, yet she and her mom would be back days later with the broken pair that had fallen off the child’s face.

The patient's mother was very concerned about cost and was aware that the warranty policy, while generous, did not cover patient abuse. The customer was not sure if she could repair the frame and was simply calling to inquire about the cost of a temple as the child had yet again dropped her frame twisting it and breaking a temple. She was not sure if a new temple would fix the problem but the mother had a very limited budget to work with, so she was going to try. I recalled my training and remembered that we had a special adapter that could be attached to the temples of the frame. They would loop around the ear and secure the frame to prevent future accidents.

During our conversation the customer let me know how difficult it was to find glasses for the patient in the first place as the little girl only agreed to wear pink! I asked the customer not to worry about cost for the moment but to ask the patient's mother what she thought of the cable adapter idea. The customer certainly was enthusiastic about my suggestion and asked me to hold while she checked with the mom, mentioning it was the little girl she was more worried about convincing! That's when I let her know the adapters were available in pink!!!! The customer was thrilled and I held on the line, waiting to see if this little girl (less than an 8th of my age) would accept my offer. When she back to the line very grateful for my suggestion, she informed me that when they were financially ready to order the frame, the mom would order with the pink cable adapters installed and inquired about the cost of them. I knew I couldn't let them leave that office without a new frame that would stay on the patient’s face once and for all. After all, our motto at Marchon is "We Help People See" and not "if you break it you buy it". I ordered the frame for the patient at no charge, applied a value added service to ensure the frame was equipped with pink cable adapters and shipped it overnight at no charge postage. Neither the customer nor the patient had to incur any cost. The reaction from both the customer and the patient’s mother was incredibly overwhelming! We were all over the moon and shared the satisfaction of knowing this little girl would be seeing like the rest of by the next day. I could hear the reactions of everyone over the phone and felt the mood totally change in to one of celebration!

This simple gesture that took me nothing more than some compassion and a few keystrokes on a key board had a positive impact on everyone involved in the discussion. I was grateful and proud to work for a company that believed in the power of "yes". The customer was astonished by our service and the patient's mother was grateful that her daughter would be in her glasses by the next day and they would stay on moving forward! As per the little girl, sure she would have the gift of sight, but she was more excited about the new pink cable adapters!

Tyler Fitzsimons – Marchon Eyewear Inc.

 

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Proactive Problem Solving with the Customer’s Experience in Mind

“Before the customer could even mention what had happened, Anderson had already reviewed the account, offered a proactive apology, and began taking action to resolve.”

Anderson has been an inbound sales agent at Millennium1 Solutions for almost a year and, remarkably, during that time, he has never received a survey which has been scored less than Very Satisfied. He consistently offers a welcoming call experience that delights the customer and makes them feel like a valuable addition to our family of Cardholders. Making this feat even more impressive, is that Anderson is also able to consistently exceed his sales targets while doing so.

Anderson’s skills were on display last December when he received a call from a Cardholder who had recently upgraded her credit card. When the Cardholder upgraded, there was a system glitch and the card was not mailed out as it should have been. Concerned that the card hadn’t been received yet, the Cardholder called us back and Anderson had to deliver the bad news about the glitch. The customer was upset that she would have to wait additional time before she could start taking advantage of the benefits featured on their new upgraded card. Anderson handled the interaction well and did everything he could to expedite having the card reissued and mailed with priority.

When the customer finally received her card, she called again to activate it and surprisingly was connected with Anderson again. Before the customer could even mention what had happened, Anderson had already reviewed the account, offered a proactive apology, and began taking action. He indicated that he remembered speaking with her not long ago. He then went on to explain in more detail the issue that occurred on the account, and while he was doing so, assessed the impact to the customer in terms of how many bonus points they were unable to earn based on their typical spending habits. Anderson offered to compensate the customer with points and the Cardholder was ecstatic. The customer truly felt understood and immediately saw the value in being considered an Elite Cardholder.

After thoroughly resolving the issue to the Cardholder’s satisfaction, Anderson reviewed with her the offers available on the account. This customer qualified for a credit limit increase and given that she was now eligible for additional benefits on the card (which encouraged her to spend more), Anderson thought this was the perfect time to share this offer with her. She accepted, and remains a happy Cardholder today.

Even though the customer had every right to be upset at the beginning of the second call given the inconvenience and repeat call, Anderson resolved the situation before she could even bring it up. Anderson skillfully put himself in the customer’s shoes and did what he felt was right for them – as he does on all of his calls. We’d like to thank Anderson for his thoughtful and professional approach and congratulate him on being World Class Certified based on the positive call experiences he consistently delivers. He’s a prime example of how a sales call can also be a fantastic, customer-centric experience.

Anderson Henry – Millennium1 Solutions

 

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Sharing a Bit of Your Own Personality Really Makes a Difference

“Injecting a bit of personality into each call helps my callers know they’re talking to the real me and not a machine.”

Every day you hear about great customer service stories, but do they all stand out as true differentiators or stories that raise the bar? Let me share with you a bit about our CSR Awaldi Stuart who does just that! As a top ranked CSR in our Contact Centre (#4), Awaldi demonstrates that he has the Cardholder’s best interests at heart by consistently looking for ways in which he can make the everyday just a little better for his callers. He uses our internal “freedom within a framework” approach to offer solutions and advice that is not cookie cutter in nature, but rather is tailored to what makes sense for the Cardholder. His can-do approach, attitude, and openness help Cardholders feel comfortable with him as does his natural way of matching his style to that of the Cardholder.

Awaldi takes the time to learn about the Cardholder and provides the same advice that he would give to his own friends and family based on their unique situation. While it may be easier to follow a script, Awaldi looks at his interactions as a moment to help, educate and provide service with flexibility, creative options and at times, a chance to go above and beyond. During the football season, Awaldi used his passion for the game to build simple and personable connections, injecting the “human element” and showing his personality in a way that resonated well with his callers.

Awaldi understands that what may be a normal call for him with a routine problem or call reason may not be routine for the Cardholder. In fact, it may be the most important priority for his caller on the day that they contact us. Keeping this in mind, he uses his compassion and knowledge to appreciate what the Cardholder is feeling, uses empathy, and targets prompt resolution. His consistency and commitment allows him to deliver world class service that is aligned to prescribed procedures while also injecting a personal touch.

Awaldi’s upbeat personality draws both his peers and his callers to him. His warm approach and genuine tone helps him gain the trust and confidence needed to take care of each caller he interacts with. He displays a positive approach even when handling challenging conversations and feels the most rewarded when he is able to turn what could have been a negative situation into a win for all. One specific example of executional excellence involved a situation where a Cardholder’s card was stolen and she required her old card number to provide to the local authorities for investigation. In this situation, the caller was an elderly client who had been through a very stressful experience having had her purse stolen while she was in a parking lot. She was very distraught, worried and over-whelmed by the incident which had occurred weeks prior, but was still very real for the client. Early in the call, it was clear that she was somewhat traumatized by the incident and was quite emotional and placing blame on herself. Awaldi was quick to attend to her emotional state by reassuring her that things like this happen and how he could only imagine how difficult it must have been for her. He skillfully and naturally empathized with her, while also affording her the time she needed to share her experience. He ensured he slowed down his pace to match the tone of the conversation and to walk her through what the next steps would be. The Cardholder needed her old card number to provide to the police officers who were investigating the theft, but unfortunately that is not information that we are able to provide over the phone. Awaldi explained to her that he could not provide such sensitive information over the phone but that if she had access to a statement she could go online and get it from her account that way. The caller advised that her son typically assists her with online account matters and that he was away on a business trip. Awaldi stepped in - knowing that she was still very overwhelmed – and provided her with personalized assistance endeavoring to help her get online. His first step was to walk her through the process of getting online as she acknowledged that she never really uses the computer. In spite of her limited computer knowledge, Awaldi knew this would be the fastest way to help her obtain the info required. He said, “We will go slow and see if we can get you into your account” reassuring her that there was no rush. This helped calm the caller quite a bit and Awaldi ensured he waited patiently and provided direction one step at a time as she attempted to access her online account.

After numerous attempts, Awaldi realized that the Cardholder’s limited computer knowledge was proving difficult, so an alternate approach was needed. Given her son was out of town and unable to assist her on site, it was time for a Plan B. Awaldi let her know that she could have the police contact us directly as a formal process exists for partnering with law enforcement when necessary. Through this process, Awaldi knew that we would be able to provide all information they required, without adding any new frustration or steps for the Cardholder. The Cardholder was extremely happy that this could be taken off her plate without her direct involvement. She said she felt relieved that the police and our credit card client could work together on matters like this. She was clearly under a great deal of stress and the fact that someone could take care of this on her behalf was a large relief. She shared how she was alone as her spouse had passed away several years ago and commented on how stressful she finds it to manage finances as he had previously handled these matters. Awaldi spoke about his own ageing parents, further personalizing the call and discussing how wonderful it is that she has her son for support. He ended the call reassuring her that as her card was now cancelled, that it could no longer be used and that she would not be liable for any charges incurred by the thieves. He reiterated our security protocols and closed the call including “we are here to take care of the people who chose to trust us with their everyday credit card needs and finances. We value your business, especially in a world where we know consumers have a lot of choices in who they want to do business with.”

Awaldi attempts to ensure every customer, during every interaction, everyday walks away feeling that they matter to us by making simple and repeatable personalized connections. Whether a conversation about the weather, family trips, holidays and even football, Awaldi believes that sharing a bit of his own personality really makes a difference to the experiences he delivers. His ability to do this well – while also balancing efficiency and other operational performance metrics – makes him stand out as a World Class CSR at Millennium1 Solutions.

Awaldi Stuart – Millennium1 Solutions

 

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Personalized Retention with Real Value-Add for the Caller

“I was proud to have been able to help the Cardholder while also saving an account in a way that was relevant and meaningful to the customer.”

As a CSR handling credit card calls, from time to time I speak with a Cardholder who would like to cancel, allowing me to leverage my retention skills. There are many different reasons why a Cardholder may choose to cancel their account; ranging from “I'm just clearing out debt” or “I have too many cards”, to product-related reasons such the interest rate or suitability of card features. These reasons are relatively common in this industry, but sometimes more complex retention situations occur requiring specialized handling, for instance when the caller is clearly upset at the beginning of the interaction.

One such example presented itself while I was still in the early days of nesting for our highest tier of service – servicing our client’s most high-value customers. Early on I knew she would be a pleasure to speak with; a very nice lady. I quickly realized that something was off in the tone of her voice that led me to believe that she was upset or just plain down. She was looking to close her account, to which I responded with a goal to learn more with "I’m very sorry to hear that, is there any particular reason why you wish to close your account today?" Initially, she advised that she does not use her card anymore so she no longer needs it. While reviewing her account I noticed that she actually used her card quite often for a prolonged period of time, but then she just stopped abruptly. This peaked my curiosity from a retention perspective, prompting me to gently probe a bit more deeply. She eventually opened-up to me and acknowledged that her real reason for wanting to cancel her account was due to a recent job loss. She stated that she was no longer able to afford to use credit so she wanted to have her account closed to help her manage her finances and prevent her from being able to just pay the minimum payments.

During the conversation, I continued reviewing her account and noticed that she had previously enrolled in the card’s optional account balance insurance product. Since she had recently lost her job I knew this product could add a great deal of value for her and that it may also retain her business offering a win-win. I took a few moments to remind her that she had this valuable insurance coverage, which she knew she had but had forgotten about its features. I reminded her of the product’s features and explained in a gentle fashion how I thought it might help her in her current situation. The explanation of the features quickly made the Cardholder considerably more cheerful and relieved. I provided her with the details and contact information she would need to initiate a claim and wished her all the best. After chatting briefly about hoping things start looking up for her very soon, she then advised me that she couldn't be happier with our services and was glad that I had told her about this feature. She couldn't believe that she nearly cancelled when she actually already had a product that could truly assist her current situation and relieve financial stress. This call made me feel terrific. It was a great experience for both of us as she was able to relieve some stress given her recent financial struggles and I was able to retain the business for our client while also testing my own knowledge of this valuable product feature. I was proud to have been able to help the Cardholder while also saving an account in a way that was relevant and meaningful to the customer.

Kaylyn Beckwith – Millennium1 Solutions

 

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Empathizing and Thinking Outside the Box

“Our client was thrilled that I was able to save a longtime Cardholder and that I even cross-sold the retail channel and their cell phone provider services to her – all in an empathetic, caring, and helpful way.”

As a Level 4 agent on one of our credit card programs, on a daily basis I deal with a wide variety of Cardholder matters; everything from declined cards to issues with accessing the online website for self-service.

Since I joined the Millennium1 Solutions family, I have often had the opportunity to sit side-by-side with our client stakeholders so they can listen to my calls. On one specific occasion, one of our clients spent the majority of a day listening to my calls. Most of them were what I would categorize as standard calls such as balance inquiries, assistance accessing our online website and many other general inquiries. The last call of my shift, however, was quite different.

The last call I had that day was unfortunately a very upset Cardholder. She was a long time Cardholder and was expecting a transaction to appear on her account that was for her sons’ post-secondary tuition. It was apparently a rather last minute payment, and it was critical that it be processed successfully or her son risked losing his seat in the post-secondary institute he had planned on attending. She further explained how hard he worked for his seat and that due to his dedication and hard work, she wanted to make sure that the payment successfully went through.

The complexity in this situation was her available credit as unfortunately, she did not have the available credit needed on her account to cover the tuition payment. She was so upset that she was fully prepared to close her account and explore her options with other credit card companies. This situation meant a lot to me as I was going through enrolment of my own eldest daughter in her post-secondary studies at that time. I wanted to do everything humanly possible to assist her and I was targeting a win-win with her son successfully enrolled in school, and her business retained for our client. Since I was currently going through the post-secondary enrolment situation myself, it was easy for me to understand her feelings and empathize naturally. This seemed to make her feel better about the situation and kept her calm while I looked into her account and explored options. I needed to investigate more deeply, so I placed her on a brief hold while I looked over her account to see what options were available. As I was reviewing her account, I noticed that the transaction had already been posted and declined as she did not have sufficient available credit on her account. It was very unfortunate as she was only a few hundred dollars short of the amount she required for the tuition payment.

I really wanted to be able to help her and to avoid the need for her to go elsewhere to obtain the credit she needed in order to have the transaction processed successfully. After looking further into the account, I found a credit limit increase offer that she qualified for. I returned to the Cardholder and I explained to her that I could increase her credit limit for her immediately and that it would not require a credit check. She was thrilled with the news because not only was it enough to cover the cost of tuition, but it would also cover the costs of books and additional items he would need.

This call was emotionally charged as during our interaction, the Cardholder also shared with me that her husband had recently passed away and along with battling grief; she was also battling breast cancer at the same time. This was one extra stressor that she really didn’t need. I was so happy to be able to assist in this small way given all the was going through. She informed me that now all of her business would go to our client’s credit card and she will be spreading nothing but positive comments regarding our customer service.

As I was processing the credit limit increase, the Cardholder made a comment about how she wished her cell phone provider was as reliable and helpful as we are. I immediately thought about our other channels and referred her to our client’s nearest retail store so that she could explore our cell phone provider services. She had absolutely no idea that our client offered those services and she expressed how happy she was that I took the extra time to provide her with the suggestion. She was ecstatic! She even took the time to say she knew that the call was likely being recorded and that she hoped that my supervisor listens and gives me a raise - to which we both laughed and then ended the call with a smile.

As I had the pleasure of having one of our client contacts sitting with me during this call, I had the added benefit of receiving real-time feedback. Our client was thrilled that I was able to save a longtime Cardholder and that I even cross-sold the retail channel and their cell phone provider services to her – all in an empathetic, caring, and helpful way.

This call has always stuck with me. In addition to my Agent role, I also serve as an Agent Trainer assisting our newest team members excel. I have recently used this call as an example in the classroom. I encourage them to smile on the phone. It's a simple tactic that truly works. Not only does it provide happiness to the Cardholder but it will also provide you the same happiness. You should always take the extra time to treat the Cardholder with the same respect you would want from others. Take the time to put yourself in their shoes, it will benefit you and your ability to provide exceptional customer service in the end. Taking the time to listen to a Cardholder’s story will always be beneficial – especially when we know they are upset and frustrated - taking take the time to find out why and connect on a human level really matters.

Trina Hardiman – Millennium1 Solutions

 

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Thank you for calling Nationstar, this is Joe!

“It is a combination of his genuine personality and strong work ethic that makes Joseph such a successful agent; he is the level of excellence that we all try to achieve.”

A simple greeting over the telephone can set the stage for any customer service call. It is all about the tone and attitude you project towards the person on the other end with just your voice. Johnson City ACT agents know this all too well since we are located in the heart of the south in Johnson City, Tennessee. Each customer interaction is handled with the utmost kindness and understanding regardless of the situation. Joseph Jablanofsky is a perfect example of our personalized service in Johnson City and proceeds to be advocate for the customers he speaks with every day.

Joseph Jablanofsky is best known for his unique opening greeting. Much like our customer service, it’s genuine and very memorable. The majority of his customers knowingly remember his name at the end of their calls. He always reminds the group that we are here to do right by our customers and make sure that we are keeping our promises. On several occasions, Joseph has volunteered to keep up with customer’s accounts that may need a follow up or just a correction made at a certain time. The customers that he comes in contact with appreciate his diligence which is shown in his record breaking World Class Call percentage.

Joe holds the amazing record of most consecutive World Class Calls in Nationstar history. He began in March 2015 and through February 2016 gathered a total of 43 straight World Class Calls. This is proof that the service Joseph lives by has successfully touched the lives of many customers.

Here is a short story that best encapsulates Joe’s best of class service:

A customer from Houston, Texas was interested in paying her loan sooner by making extra payments towards principal, but was confused on the process and logistics of how to get this done automatically each month. She had reached Joe in Customer Service. The customer was in a situation that was very new to her and needed guidance on how to reach her goal. Joseph had no hesitation and went straight to work. Joe’s tone and clear instructions set the customer at ease. He ordered her a coupon book and patiently answered all questions she could think of. The call had to be transferred to the Bankruptcy Department for additional assistance, but the customer left us her feedback from her experience with Joe:

It is a combination of his genuine personality and strong work ethic that makes Joseph such a successful agent; he is the level of excellence that we all try to achieve and that is why we are nominating Joseph Jablanofsky from ACT in Good Ole East Tennessee. According to our Customers, Joseph is the #1 servicing agent in all of Nationstar’s SQM history and it would mean a lot to Joseph and the Johnson City team to have a teammate take home Top CSR SQM Award!

Joseph Jablanofsky – Nationstar Mortgage

 

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I Do It With My Heart

“I did not leave her alone on the phone because I felt the need to treat her like my own grandmother, and she was counting on me.”

How do I even begin to explain world class customer service? I can say a lot of words about world class customer service. I can use a bunch of adjectives to explain what it really means, but with so many organizations focused on the same thing, I began asking myself “What really is world class customer service?”. All I know is, I come in to the office every day, set up my tools, have a few laughs with my friends at work, log in, and start answering calls. Every one of us does this job every day, but how am I different from the rest?

In our industry, we throw around phrases like “customer intimacy” and "customer-centricity". We use words like “delight” and “exceed”, but are those enough to be able to see if I have provided world class customer service? Imagine you’re an employee being asked to deliver a “world-class customer experience”. Where would you start? What would you do? Would you try to “delight”? Get “intimate”? Solve their problem? How do you do that? What I know is, when I log in to the phones each morning and start answering calls, I do it with my heart.

When I first started taking calls I had many challenges. My product knowledge was poor, I wasn’t comfortable using the tools I needed to do the job, but one thing I always had from the beginning was that I knew how to talk to people, and I put my heart into each call I took. I cannot remember all the calls I received since I started working in the industry, but among all the thousands and thousands of calls I took in my entire life in this industry, there was one call that stands out. To this day, it is something that remains in my mind and in my heart.

It was a Saturday night shift when all my friends were out partying, but I’m in the office working when my phone beeped. I delivered my opening spiel, and I heard a hysterical, crying voice of a helpless old woman on the other end. She said she received a threatening letter from Nationstar telling her that we will foreclose, and her property will be taken away from her. I had a lot of things swimming in my head to tell her, but I held up and let her vent.

She was crying all along and was having difficulty breathing, which I would probably also feel if I was in her shoes. She was in a desperate situation, all alone, thinking that nobody can help her out. After an emotional outpour that lasted several minutes, she paused, probably to catch her breath, and there was a moment of silence. I could still hear her sobbing.

I opened my mouth and gently uttered, “I am here to help you, but before we get started, I need you do to me a little favor, is that okay with you?” She said “Yes, what is it?” I politely said, “Can you please get yourself a glass of water first and drink before we start resolving your issue?” She said, “Okay, give me a minute” in a trembling voice.

From that moment on, I knew that I got her to trust me, and that I could help her with her ordeal. We discussed her situation. I did what I had to do. I had to talk to another department to get her a payment plan and we eventually resolved her issue. I did not leave her alone on the phone because I felt the need to treat her like my own grandmother, and she was counting on me. I didn’t want to let her down. She was relieved and very thankful. She even complimented me for what I did for her, which I appreciated, even if my manager did not hear it, but the part where I was deeply touched was when she said, “Thank you for your help. You are an angel.”

To this day, I always strive to get the same kind of reaction from my customers when they need me. The recognition from my manager/company is appreciated, but the feeling I get in my heart when I help someone is the most valuable reward to me. It feels good to truly help someone that needs it.

Russel Valendo – Nationstar Mortgage

 

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Preparing For An Urgent Transplant

“This was no longer just a conversation between an insurance representative and a customer – it was one person listening and helping another person.”

On a typical day in our call center, a Customer Service Representative will handle dozens of calls. Most of them are routine – questions about chiropractic visits, Health Savings Accounts, and dental cleanings. But, every once in a while, we have the chance to make a real difference in someone’s life. In those moments, Heather finds a way to connect at a deeper level and deliver world class service that far exceeds the customer’s expectations.

On a Tuesday morning in late October, Heather found herself on a phone call that would tug at her heart strings and test her customer service skills. The woman on the other end of the line sounded concerned and anxious. She told Heather that her husband was diagnosed with chronic liver disease, and they were preparing for an urgent transplant. It was clear to Heather that this phone call would be anything but routine.

Heather is an expert at understanding her callers and adjusting her tone to match theirs. On this call, she quickly shifted gears. Her voice, usually upbeat and cheerful, now sounded softer and especially empathetic. This was no longer just a conversation between an insurance representative and a customer – it was one person listening and helping another person. As the story unfolded, Heather learned that the woman and her husband had traveled from Alaska all the way to Florida for the transplant. They were staying with relatives and working with the local hospital. Her husband was put at the top of the list as they waited for a new liver. The doctor had said they needed to move quickly so they could be ready for the operation. Heather promised to explain the health plan coverage and also do whatever else she could.

The woman was confident that they had found a great medical team for her husband. But she didn’t know if the hospital was in her health plan’s network, and she was worried about how much this transplant would cost. Heather started by reviewing the family’s account, and she determined that they had already met their out-of-pocket maximum for the year. This meant that, if the healthcare providers were in the network, the health plan would pay the entire cost of the transplant and all related services – and the family would owe nothing. The woman was now holding back tears as she said to Heather “Oh my gosh, thank you! I want to cry.” Heather offered to call the hospital in Florida to confirm their network status. She then called the woman right back to tell her that the hospital was in the network. The health plan coverage was confirmed. The woman could now focus on spending time with her ailing husband and taking care of him.

In the midst of uncertainty, Heather gave this woman some clarity and peace of mind. But it was more than just facts and numbers. Heather connected with her at a personal level and showed that she really cared. She demonstrated true compassion for another human being, and she helped to lift them up. The woman’s anxious tone vanished. There was now a smile in her voice, and even occasional laughter. Heather decided to offer one more thing to resolve the call and help the family. She arranged for one of our Case Manager Nurses to stay in touch and work with them through this difficult time. As the conversation was ending, the woman took a moment to express her gratitude. “Thank you Heather”, she said. “You made my day, and it hasn’t been like that in a long time. So I thank you very much.”

Heather Sundheim – Premera Blue Cross

 

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How to Be a Hero for Our Members

“Brooke tapped her resources and experience to devise some options.”

When Brooke Jobe received a call from a Medicare Advantage member, at first it seemed like a simple inquiry about obtaining a prescription. But when he mentioned that in an effort to save money he had a gap in health insurance coverage and was out of insulin, Brooke realized the situation could be far more serious. Concerned about the member’s health, Brooke gently began asking probing questions to try to get more details about his condition and conducted a welfare check of sorts right over the phone. “Are you feeling OK today?” she queried. “How are your sugars?” Brooke wondered if the member had anyone there with him to help and learned his wife was away. At that point, she knew she had to do something to help the member.

Brooke tapped her resources and experience to devise some options and proposed them to the member.

The member chose a low-cost program through the insulin manufacturer. Brooke explained that the member would need to submit an application, which would take 24-48 hours to process upon receipt. She moved quickly through each potential solution because by this time she knew he needed insulin now. While investigating the options, Brooke discovered the member qualified for a voucher for one free dose of insulin. Because of her persistence, she was able to get the member an additional two doses of insulin for less than half the amount he had been struggling to afford, and it was available right away from his local pharmacy.

When asked why she is so committed to helping our members, Brooke explained, “I enjoy helping people, and in Medicare Advantage we have the opportunity to work with seniors. They are from a different era, and when you help them it’s like you’ve really, really helped them. They are so appreciative and sweet, and sometimes you could be the only one they’ve talked to all day or for a few days.”

Brooke’s actions show us exactly how to be a catalyst to transform health care – and how to be a hero for our members

Brooke Jobe – Regence BlueCross BlueShield

 

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It’s Truly a Talent

“Being a Customer Service Representative is truly a talent of wearing many hats.”

I have always believed that being a Customer Service Representative is a difficult job that not everyone is able to excel at. People that are not in the field often have preconceptions about our jobs. They often think that a CSR’s job is simple and don’t realize how challenging these positions could be.

Because we are on the front lines, we are often the ones who must manage all types of client emotions including any crisis situations. We must constantly fulfill our customers’ high expectations; deliver exceptional service, keeping our “cool” even when clients get aggressive; prioritize our company’s objectives while keeping a smile on our face in order to ensure world class service at all times. Being a Customer Service Representative is truly a talent of wearing many hats: Friend, Psychologist, Financial Advisor, Seller, Lawyer, Accountant, Life Coach, and Tax Specialist.

Even though my job is very demanding and stressful at times, I would not change my field as servicing customers is extremely rewarding. What I love about my job is the opportunity to bond with my clients. I get to assist them in their journey as my subsequent actions will determine how to best direct them in getting resolution resulting in an eventual unforgettable customer experience, which to me is a privilege. Our client requests are frequently very complicated, but at the end of the day they are relying on me to get them an answer or find a way to get it done.

I recall one event in particular when a client called regarding an over contribution to her Tax Free Savings Account. She received a letter from the government advising her that she went over her contribution limit by roughly $20,000 in which she was charged a 1% penalty of the over contribution amount for months. I could feel the client’s panic in her voice, and because she was a widowed senior, I could understand how lost and desperate she felt about dealing with this issue alone. Our client explained to me that her husband used to take care of her finances. What I reminded myself while speaking with her over the phone is that she could have been my grandmother and therefore I took this situation very seriously. The Client was not at all comfortable using technical devices such as computer or fax. I asked her to provide me with her financial advisor’s name so I may reach out to him or her. Once she provided me with this information, I called the branch representative and asked him to forward me by fax the client’s government letter so that I may open an investigation. A day later, the client visited the branch and I was able to start working on her case. After researching the client’s transaction history and statements, I found the problem! The Client did not do anything wrong, but in fact there was an error in reporting the transaction that brought her account to be over the specified limit. This had to do with a transfer request from one TFSA account to another that had been coded incorrectly as a contribution deposit. In fact, not only was the client fine and within her contribution limits for her Tax Free Savings Account but she was also entitled to get a refund for the penalties charged by the government. I called the client back shortly after our initial conversation and advised her of the situation. She felt very reassured and was thrilled to be informed that she will get a reimbursement for the fees she incurred considering that this was a reporting error.

This experience and in particular the client reaction after seeing full resolution of the issue is the kind of story that to me makes me feel like a Super Hero. Now when the client calls back, she always requests to speak with me. I feel trustworthy and connected with this client. I know she will always be thankful and grateful for what I have done. An experience like this is very rewarding and motivating which makes me feel special as a Customer Service Representative who could make all the difference in the world.

Mona Rghif – Scotia iTRADE

 

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Victim to a Clerical Error

“The key to being a World Class customer service representative ultimately comes down to persistence and treating the customer’s concerns as though they are your very own.”

My favorite aspect of customer service is the opportunity to apply my talents in an effort to make someone’s day. I can honestly say that nothing is sure to make my day like hearing from a customer that I have made their day. Every once in a while this opportunity comes about in the most unexpected of ways. We are all no doubt familiar with that dreaded call which begins with our client saying “I want to speak to a manager”. Already the stage is set. The outcome looks bleak and we find ourselves in a position which is likely to be challenging to say the least.

Picture a client who has fallen victim to a clerical error. They had previously spoken with three different representatives, who were either unable to identify the issue, asked our client to provide much unnecessary documentation, or failed to follow-up and contact the client, let alone rectify the problem. At this stage, the client’s trust in the organization is clearly broken, marred by misinformation and misgivings, but is hopefully not beyond repair; which is where I come in.

A good customer service representative is knowledgeable, empathetic, fastidious and knows when to listen. A great customer service representative will – in addition to these traits – ask the right questions; leave no stone unturned; and be an avid advocate for their client in their uncompromising pursuit of resolution.

Step one was to make a diligent effort to understand the nature and history of the situation. Once I had obtained all the pertinent facts, I asked our client to allow me some time to investigate the matter and assured her that I would contact her the following day. Due to her past experience, persuading her took much pleading. The next step was to identify a solution, which proved to be somewhat more difficult.

The situation as I saw it was simple. A mistake had been made, the result of which was that funds were erroneously withdrawn from an incorrect bank account (an account that our client shared with her father) instead of her own personal account. The fact that her father might miss his mortgage payment, which was due within just two days, made the matter somewhat more pressing. She had done her part and contacted us as soon as she was aware of the situation. Could we not just reverse the transaction? Apparently not. I have always believed that rules are to be followed; a belief I hold to this day. However, I do not believe that rules are not to be questioned.

The next step was to search through our procedure manuals to identify the obstacle and hopefully find a solution to our dilemma, which would inconvenience our client as little as possible. Having identified no obstacles and found the optimal solution, I raised the matter to senior management.

I am fortunate enough to work for an organization which will always put the client experience first, challenging all of us to do better every day. When I questioned the existing process and challenged our policy, I was pleased to see that senior management was highly receptive to my concerns. As it turns out, the error was the result of a gap in our process and an outdated policy.

Our department then went on to explain the articulate the situation to our operations team. Despite initial resistance, it became clear to them that the resolution was simple and that both our process and policy needed to be updated to address the current environment and avoid situations similar to this occurring in future. The best thing about situations like this is that they help us an organization improve our client focus and allow for our support departments to embrace this philosophy.

The very next morning I called our client to deliver the good news and inform her that the funds would be returned to the bank account that afternoon. I could clearly sense her relief upon learning that no further action was required from her or her father and she could not be happier as she said “Thank you so much… You’ve made my day”.

For me, the key to being a World Class customer service representative ultimately comes down to persistence and treating the customer’s concerns as though they are your very own!

Sammer Salama – Scotia iTRADE

 

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Taking Ownership of the Problem

“The client had gone from frustrated and confused to relaxed and grateful.”

“Hi there! This is Ruby speaking; may I please begin by confirming your policy number?” I often times repeat this opening question in excess of 70 times a day. When you initially answer any call, you never know what is awaiting you on the other end of the line. It is a complete mystery. This can pose an interesting challenge. Every call requires you to identify the caller’s request and efficiently find a uniquely tailored resolution that meets his or her individual needs. However, what remains invariable is that as a CCR you have the opportunity on each and every call to leave lasting impression with the client.

Who is Sun Life Financial? As CCR’s we are often times the first line of communication with our clients, therefore we hold a great deal of significance in terms of what our clients think about our company as a whole. I take this responsibility seriously and take this mindset into account with every interaction I have with our clients. Often times this means taking the extra time to really listen to what the client is saying, acknowledging his or her concerns, and thinking outside of the box so the client can disconnect the call entirely satisfied with his or her experience. In the story that I am about to tell, I was able to do just that.

I started as I always do. “Hi there! This is Ruby speaking; may I please begin by confirming your policy number?” The woman on the line replied by asking me to speak very slowly and loudly. I indicated that I could definitely do that for her, and repeated my name, and asked how I could be of assistance to her. The client explained she has Multiple Sclerosis and has difficulty speaking and difficulty hearing. At this point I recognized that this phone call was going to be different than most others that I handle. I started off by assuring the client that I would definitely be mindful of that and explaining I needed to verify her identity. On a standard phone call the entire process of introducing myself, collecting the client’s policy number and verifying the caller’s identity takes thirty seconds to one minute. Because of the pace I had to speak at to make sure I was being considerate of the caller’s request to speak slowly and annunciate each syllable, the entire process took about 15 minutes. I wanted this client to understand that I cared about accommodating what she had requested of me and I was going to do whatever I could to help her.

After authentication she continued to explain to me that her life insurance products provide her with peace of mind and that she is very confused and upset by a statement that she recently received for one of her policies. She was guaranteed by the advisor that as long as she continues to pay her premiums her policy will never expire. However, the statement that she received indicated that her policy will end in 29 years. She indicated that her grandmother lived to be 100 and she is not comfortable having a policy that will expire at any point. She was clearly extremely upset and confused by the communication that she had received. She had also mentioned that she did not wish to deal with her advisor and prefers that we not contact the advisor regarding her policy for personal reasons.

Just as the client was finishing explaining all of the details of her issue, the entire CCC experienced a CSW outage. We were being advised to ask all callers to call back either later in the day or the next business day. I knew immediately that I would not be satisfied with the experience I provided this client if I simply advised her to call back. She needed answers, she needed a solution and most of all she needed reassurance that everything was taken care of.

I proceeded to do my best to explain the workings of the policy to the client. I explained what the statement meant and how she could ensure the policy remained intact for the remainder of her life. Though she listened intently, I could sense by the tone of her voice she was still not completely satisfied. I then thought to ask the client, “What exactly can I provide for you, in order for you to feel at ease about this situation?” She paused and thought for a moment.

She asked that we write her a letter. The letter needed to be in large bold font and well-spaced to accommodate her disability. The letter needed to outline the parameters of the expiry of all of her policies, and completed as soon as possible. I assured her that we could absolutely do that for her. I then took ownership for this solution by advising her that I would personally make sure this was completed for her. I made note of her policy number, and planned to check on it the next business day to make sure that the information I had collected was received and acted upon by the appropriate department. At the end of the call when I had noted all the details of our conversation, all of her concerns and exactly how she wanted the concerns addressed, I asked the client if there was anything else I could do for her. The tone of her voice softened. She explained that she had never spoken to someone in a customer service role that was so committed to her complete satisfaction, and was so willing to adjust to her specific needs. She thanked me over and over again and told me that she would finally be able to sleep that night, after worrying about this for days on end.

Often times at the end of my day, I reflect and think what could I have done better, and what did I do well today? On this particular day I knew that the interaction I had with this client left a lasting impression. I had gone above and beyond to find her a unique solution, by being understanding, patient, and solution oriented. I took ownership of the problem and the solution that we had reached together by providing my personal assurance that the requested steps would be taken promptly. By the end of this interaction, the client had gone from frustrated and confused to relaxed and grateful. I pride myself on playing an integral role on the Sun Life Financial team, and working continuously to achieve complete client satisfaction.

Ruby Sahota – Sun Life Financial

 

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Finding A Solution

“In well under ten minutes this member's experience had gone from being unpleasant to extremely satisfied.”

I took a call in late summer of 2015 from a member that I could immediately tell was extremely upset by the tone of her voice. I knew right away I would have to do everything I could to change this by the time I was finished with the call.

When I asked how I could help her she explained to me she had been trying to make an online claim submission for a few days now and that this was her third time calling for assistance in how to do so. I asked her which step she was having difficulties with and she told me that once she got to the last step of submitting the claim there was an error message that stated she must submit her claim by mail. The reason she was so upset by this point was because during her first two calls she was assured she would be able to use the member website for her claim and would not have to mail it to us. It was a rather expensive drug and she needed the money back as quickly as possible.

I told her I would help her resolve her problem and see why the error was happening. I confirmed online claim submission for drugs were in fact available for her plan. I requested the Drug Identification Number for the medication she wished to submit. I took down this number and started searching through Siebel to see if there was anything in particular to it that would prevent an online claim submission.

Once I had searched the drug in Siebel, the expense code came to INJ00 (injectable drug). I knew I had previously seen a note in our Knowledge Management tool (KM) about this expense code and was able to find exactly what I was looking for. The KM stated "INJ00 cannot be submitted online, and must be submitted by mail" which explained why she was getting the error message.

I informed the member of my findings and apologized for the fact she was told differently on previous calls. However, she was still upset that she had spent so much time that entire week trying to submit the claim because she thought she was the one doing something incorrectly to cause the error. I apologized again for the misinformation but I could tell she was dissatisfied. I knew I had to come up with another option and asked her to allow me some more time to see if there was something else I could offer to make her experience a better one.

I started searching and recalled seeing a post on the Customer Call Center Homepage under "Knowledge for you" about Digital Image Capturing that had started early July 2015. I located the past post and read the facts about it, and discovered that claims such as Injections that cannot be submitted on a computer, can be submitted taking a picture using the smart phone app. I went back to the member, asked if she had a smart phone, and if so what kind. She informed me that she has an Apple iPhone. This was perfect! The Digital Image Capturing was only available to iPhones at that time. I was so relieved that I now had the best option for her and she sounded excited too when I told her I found something to resolve her problem. I told her that if she did not already have our Sun Life mobile app that she would need to download it from the App Store. She had questions about the login information required and I assured her it was the same as the member website.

By the time I had finished explaining how to submit the claim, from which option to choose to how it will ask for a picture of her receipt, her tone and feelings towards the situation had completely changed. She told me she couldn't thank me enough for not only figuring out why she was getting errors but for finding a solution that made her claim submitting experience an even simpler and faster one.

In well under ten minutes this member's experience had gone from being unpleasant to extremely satisfied. I was not only proud of myself with how professionally I handled and helped this caller, but I knew that I was making a difference in the Group Benefits Call Center.

Stephanie Motovsky – Sun Life Financial

 

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Just in Time

“She went above the call of duty.”

A member, called to let VSP know that Carol helped save her eyesight. The member was very emotional during her call and shared, "I wanted to let you know the jewel you have in Carol and that her assistance saved my sight.

I have been seeing the same doctor for the last 10 years or so, and have been having trouble the last year and a half with cataracts. I called in to express my concerns after my most recent eye doctor appointment because I was still having trouble seeing with the glasses the doctor prescribed. I was fortunate that Carol took my call. She was genuinely vested in my situation and took the time to listen to my story. I wanted a second opinion and Carol offered for VSP to cover the additional examination.

The new doctor was fantastic and he was able to help me. He noticed the cataracts had already begun to attach into my retina, and had I waited any longer I would have needed a retinal specialist and could have potentially been left blind. I should have had the cataract surgery two years ago. Carol contacted the new doctor to make arrangements to cover my examination. She went above the call of duty by also covering new lenses and a frame after my cataract surgery. She made this whole process effortless and I am so very thankful she answered my call!"

Carol Elder – VSP Vision Care