How many times has this happened to you: You call the customer service line for a product you purchased or a service you’ve just employed, and it becomes a fun game of basketball… you’re bounced around from service rep to service rep without resolution, only to finally declare “Can I just talk to your supervisor, please?”. And it’s then that you finally get the results you were looking for. Why can’t the front line customer service reps be more empowered to make decisions?

When it comes to a person’s health care, this doesn’t make sense on any level, especially when the end result leaves people to suffer. As a director for a large customer service center, this is a little hard to ignore. For starters, a mishandling of a call regarding a person’s health condition could easily lead to more and costlier problems. But any time a representative can’t answer a question, or doesn’t know where to get an answer, it makes the entire system that much less efficient, and more unpleasant.

This is why CareSource (the company that employs me) supports empowering our Front Line staff. We believe questions that come in to our call center should be resolved there, and shouldn’t have to trickle up to the corporate level executives in order to get the attention they deserve. By having this focus, our members and providers can get the answers they need on the very first call.

How We Empower our Front Line
At CareSource, each call center representative goes through an entire month of training to ensure they are fully prepared to answer the variety of questions that come their way. We’ve shifted our focus to think less about blanket responses and more about helping the individual we serve get what they need when they need it. Staff also has tools to help them find their answers quickly along with an assist line to get answers for questions they may not know. As an example of ensuring service representatives have the knowledge they need CareSource had customer service representatives swap jobs with claims analyst for an entire month, so their knowledge base is vast and they stand ready with answers to solve issues without the need to always refer to another department. This entire process is designed to ensure the caller’s needs are put first.

The Outcome
Motivated staff. They’re a lot more than just phone operators. They are the face of CareSource. And, they take that responsibility and the company’s mission of making a difference in the lives of underserved people to heart. You can see it each day as you listen to our members’ stories, and realize how the answers we gave and the compassion we displayed may have just saved a life.

The CareSource Front Line customer service staff is the perception that our members are left with each time they contact our office. If we treat our members with dignity and respect, that bodes well for how they perceive our health plan. It sets us apart as an insurance company that focuses on their members – not profits. A Front Line that gets the job done for members, providers and the organization. A novel concept. Probably another important concept to consider as we look at models to reform the health care system, because it means better access to care with less stress and lower costs all around.

CareSource is among the largest non-profit, public sector health plans in America with a scalable model ideal for health care reform.

One Response to “What Starts on the Front Lines…Stays on the Front Lines”

1. Juannlia Brown says:

   October 9, 2009 at 10:21 pm

   I enjoyed reading this article. It drives home an important point of how important our front line associates are in providing dynamic service to our members right from the start. Our front line service associates are the face of CareSource to our members and providers! Kim – thank you for opening this dialogue. I look forward to future articles.

Author : Kim Gibson

Director, Service Operations, CareSource More than 15 years of leadership and call center experience. Oversees CareSource’s Member Services, Provider Services, Member Grievance and Appeals, Provider Appeals, and Quality departments.