Success Stories
Mary Terry — Blue Cross Blue Shield North Carolina
Mary Terry goes above and beyond what members need, helping to ensure our members are happy and find value in our products/services. Mary takes her job very seriously. She treats every member with the utmost respect and does whatever is necessary to ensure their concern has been resolved.
Mary is an advocate for First Call Resolution (FCR) and strives to ensure the members’ needs are met on every call. Mary handles every member interaction gracefully. She always exhibits the utmost professionalism when dealing with members, even when they are difficult with her. Mary cares about the company and its bottom line, and it shows in her level of member service.
Mary always meets deadlines and helps members in the fastest way possible. Many members request her because of her efficiency as well as her great verbal communication skills. She can build a rapport with any member, helping him or her to feel at ease right away. Mary had a World Class Call certification percentage increase of 18% from 2021 to 2022. Taking her from 78% in 2021 to an astounding 96% in 2022. Mary has the highest percentage of World Class Call certification in the contact center. She is our #1 most improved CSP for the SHP line of business!
It is with great pleasure to see the growth and dedication that Mary exudes. Due to the hard work and determination that is displayed in each member interaction, she is an ideal candidate to represent Blue Cross NC for the CSR Top Improvement Award.
Clifton Hardy — BlueCross BlueShield of South Carolina
Clifton, fondly nicknamed “The Detangler” by our Vice President receives kudos regularly and we often say, “The Detangler Strikes Again!” He has a special way of connecting with each and every member in such a personable way. They know he is listening intently and understands their issue and trust that he will get it resolved for them. He demonstrates such warmth, compassion, and respect. Further, he follows through to meet his commitment to each member. “The Detangler” is excellent at researching and uncovering the root of the issue and is tireless at follow-up to get timely resolution for our members.
Here are just a few amazing comments from our members:
- “Jana called to say that words cannot describe the type of service she just received for Clifton. She said she would buy Clifton a steak dinner if she could since he helped her so much. She would just cry tears of joy from the stress he took from her. Jana says he was just so kind and patient. He took the time to really look into her issue to help solve it and she didn’t feel pushed over. Thank you Clifton for the great customer service to our member!”
- “Jena wanted to give her first-ever kudos to Clifton. She stated she normally doesn’t praise CSRs but Clifton went beyond what most people would typically do. She stated people usually just push her under the rug but not Clifton. She told me he took hold of the situation and called the provider to get the situation resolved. She doesn’t feel that her bill will now go to collections. This is also a DOUBLE KUDOS since she had her cousin on the line with her. The cousin even stated she was really impressed at how well he handled the situation and took the time to resolve it for Jena. Wow! Way to go Clifton.”
- “Just got a call from Neida who says that Clifton did a great job on her call. She says that he was very polite and very meticulous, making sure all her questions were answered and inquiries were resolved. She said it was a pleasant call.”
- “He was fantastic and if she could rate his services today it would be 5 stars.”
- “Clifton went beyond his scope of duty to ensure my issue was handled as a priority”. The customer also mentioned that she hasn’t received customer service like this in a while and when it’s this good it must be recognized!”
Clifton has a gentle spirit which is transferred over the phone along with the gentle tone in his voice. He is a team player that willingly assists his peers and management. He handles the most difficult call with ease and does a great job of controlling the situation and showing how much he cares. At BlueCross BlueShield of South Carolina, National Alliance Division, we want to focus on improving our FCR as we feel it is paramount to meeting our commitment to our members. Recently, we embarked on a C.A.R.E. campaign that focused on providing a service experience that our members can feel because that is what they will remember most. During the campaign, we focused on care words such as: Courteous, Appreciative, Reassuring, and Empathetic. With each, we explained what they mean and why they are important and how to use them in a way our customers can feel. Our coaches monitored calls in search of those that exemplify the C.A.R.E. characteristics, as well as our call strategy components of BLUESteps. We saw an increase in our advocates showing more care and providing world-class service. Clifton is the epitome of C.A.R.E. based on the amount of kudos our members take the time to provide to him.
Kiran Klar — First West Credit Union
Kiran is one of our most modest, fly-under-the-radar advisors. She’s the first one to share credit with a colleague or brush off a compliment or recognition with a simple “no problem.” And yet Kiran is one of those team members that you know is quietly holding us all together; from training new team members, to filling in on our admin and fraud support desk, to taking on behind-the-scenes pieces of work that require significant investigation. Kiran is never one to say “no” to anything that will help our team to deliver a great customer experience. This context is important because like so many workplaces, our days are filled with a combination of exciting projects, and those less-than-exciting but painfully necessary bodies of work. A great example of this is the administratively heavy tasks associated with Powers-ofAttorney and Estate account calls. Inquiries in these areas are usually very specific and require a deep working knowledge of several procedures and legal rules, and therefore it’s extremely tempting to simply refer these calls to other departments. Recently, Kiran received a call from a gentleman who initially was calling with a request to be transferred to a specific in-branch advisor, who unfortunately we quickly realized had left the organization. Kiran immediately asked if he would be comfortable disclosing the reason for his call, as to determine if she could help him on the spot. He shared that he was the Power of Attorney for his elderly mother, whose health was rapidly deteriorating, and that he just learned how she was behind in paying several of her bills including her rent. On top of it all, now that the mother had moved into long-term care her pensions were no longer covering her rent – meaning her budget and banking needed an overhaul. The caller engaged with us under the pretense that only the local branch advisor whom he previously met would be able to help him, and he was starting to panic, but after only a few minutes on the call with Kiran, he became audibly more relaxed and increasingly confident that he was in excellent hands. Kiran was able to reimburse some late fees which relieved some financial strain and provided him with some valuable take-away advice and recommendations. The caller, who lives on the other side of the country, was beyond appreciative that he was able to receive this level of care and service over the phone.
This isn’t an isolated example of Kiran’s high standard of service and follow-through. Another example included Kiran providing some valuable advice regarding inheritance money that her member hadn’t invested in over a year, simply because they didn’t know who to ask for help. Kiran was able to guide him in the right direction and help him establish a plan that would put him on a path to a financially secure future. One member who spoke with Kiran was quoted as saying they were:
“Pleasantly surprised because I thought it might be more challenging than it was, but it wasn’t….my experience has kind of showed me that maybe next time…instead of going to my branch…I should just call that number and it might be actually more quickly resolved…more immediate.”
That same member described the service experience as “wonderful.”
Other members highlight their experience with Kiran as having “clear and explicit” communication, that she is “very helpful”, and that “she was fast, she knew what she was doing, and she knew exactly what I was talking about right off the bat.” But if you ask Kiran, she would simply and modestly say she’s just doing her job, helping her members, one phone call at a time.
Troy Ray — Florida Blue (Federal Employee Program)
As a customer service representative for Florida Blue, I truly believe that treating the callers in the same manner which I would like to be treated will show value and satisfaction. Whether they are active members, ex-members, providers, or other insurance agents, I start every call by listening to their concerns. Maintaining current knowledge of the services and providing the callers with exceptional customer service is something I take pride in delivering on every call.
There was one example that stood out to me from 2022, a call from a member, who is one of FEP’s ex-members. I listened to him closely as he desperately told me about his new health insurance company and how they would cancel his policy if he didn’t send in a letter showing his exit date with FEP. As I continued to listen to his concerns, it became evident that he no longer lived at the address we had on file. At this point, mailing a letter was not an option. Utilizing the tools and training I received here at Florida Blue I was able to identify his issues and I offered to contact his new health insurance directly and request their fax number. Unfortunately, I was advised they did not have a fax number for me to use. When I returned to inform him of the news, he informed me that he had set up an e-fax and I could send the letter directly to him.
After receiving the fax, the member was very pleased with my due diligence, knowledge, and time and effort I put into his issues, even though he was no longer an active member. By listening to this caller’s needs and doing what I would want someone to do for me, I showed him that even though he is no longer a member of Florida Blue it will always be our pleasure to serve him. It is my mission here at FEP, to help others and I strive every day to make a difference in someone’s life.
In response to my interaction with this member, he graciously shared his appreciation with my leadership:
“Our member Michael wanted FEP to know that Troy Ray was outstanding! he was pleasant, efficient, and knowledgeable.”
This was only one of many success stories I have had the pleasure of being a part of here at Florida Blue. Assisting members daily with respect, educating them on how to understand their benefits, and helping them understand how they can best be used to support whatever situation they may be facing is something I look forward to every day.
Vanessa Harper-Bryan — Regence BlueCross BlueShield Plans (Federal Employee Program)
Remarkable Improvement from 2021 to 2022
Vanessa Harper-Bryan should be considered for the SQM World Class Call Improvement award due to her remarkable improvement from 2021 to 2022. She actively drove her own development as a Customer Service Professional (CSP) and worked day in and day out to ensure she was meeting her goals. Vanessa was hired as a CSP in 2021; she was trained and has only worked for our call center in a virtual capacity adding an extra level of difficulty as it is not always easy to pick up best practices when you are unable to hear your peers on calls.
From 2021 to 2022, Vanessa showed an overall improvement of 22% which was higher than any other individual in our Plan (not just our department). Throughout the year she was open to feedback and asked for best practices from peers, leaders, and other departments to help improve her service to members. Vanessa consistently put the needs of our members first earning World Class Certification on 93% of her calls!
Due to her commitment to serving our members, Vanessa was one of our first CSPs to participate in a hybrid opportunity in which off-phone time was awarded to assist in aging tasks. These tasks included updating privacy information, reviewing advance benefit determinations, and routing medical records. Vanessa picked this role up quickly, adding value to other departments while continuing to serve members behind the scenes. In addition, Vanessa could always be counted on to support new employees with inquiries and provide thoughtful feedback when necessary. In November of 2022, she was promoted to our Appeals and Grievance team where she is responsible for thoroughly reviewing concerns from members and providers, ensuring that all necessary options have been exhausted, and providing the outcome of tough decisions.
Vanessa’s dedication to her improvement in the 2022 year, involved building trust with not only our members but the service department. She showed courage every step of the way and earned this award.
Comments from Members:
- “She had the solution quickly and completely.”
- “The rep was very knowledgeable about my situation was able to look into the case very quickly and resolved all of my questions.”
- “She was competent and polite and efficient, you know just very good at doing what had to be done and you know, I think that's awesome.”