The challenge: Improve call quality by accelerating agent time to proficiency
Trainee member service agents for a major regional non-profit plan needed to quickly become proficient in accurately answering health plan member questions. There are financial penalties if an agent gives a plan member incorrect information about their eligibility and insurance benefits, and the plan's agents needed to answer questions about multiple plans, each with its own coverage nuances.
Many of the newest service agents had no previous experience in the healthcare industry. All were working from home, covering three lines of business. With relevant data spread throughout multiple client systems, agents struggled to find the appropriate information in a timely way during training calls. These difficulties hurt agent retention. The challenge was to help agents progress through the client’s curriculum more quickly and with greater success to build their competency and confidence and ensure quality interactions with members.
The solution: Augmenting agent capabilities with AI-enhanced decision tree
Firstsource introduced a digital AI-enhanced decision tree into agent training. The tool prompts agents through optimal call flows to ensure they interact effectively with members. Agents can use the tool’s embedded links and keyword search functions to rapidly find the relevant information within the client’s systems, including its customer relationship management (CRM) system.
With more than 230 agents working from home, the client needed a way to remotely monitor and evaluate performance. The digital decision tree offers real-time tracking so supervisors can see how much time an agent spends on different steps in the call process. That enables finetuning in both training and live situations. In addition, the tool logs the keyword searches for review. This data can help the plan understand what kind of questions its members are asking and/or whether agents need additional training on how to handle those queries.
The results: Higher performance with more first-time resolutions and reduced call times
We first piloted the decision tree solution, using a test group with access to the tool and a control group that did not. Those trainee agents who used the tool rapidly improved their performance. Simplifying agent decision making with clear guidance from the tool led to a 10% improvement in quality performance among new agents. The results were so impressive our client authorized us to implement the tool into its live call center environment for use by all agents.
Since implementing the tool in its production environment, our client has seen average call handling time (ACHT) reduced by 25% and an increase in first call resolutions. The digital decision tree helps increase agent productivity by enabling them to quickly become familiar with call procedures and our client’s guidelines and policies. That equips agents to provide members with accurate, comprehensive information, improving the quality of interactions. That leads to greater agent and member satisfaction and improves the retention of both.