Welcome to the third edition of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series is designed to provide health plans with actionable insights and expert advice to navigate the complexities of the open enrollment period successfully.
In our first two editions, we covered critical areas of compliance with insights from our Compliance Officer, Milonda Mitchell, and explored best practices for enrollment processes with Rosalie Torres, our Associate Director of Enrollment and Fulfillment Operations.
In this edition, we’re turning our focus to the heart of member engagement during open enrollment: call center operations. To guide us through this vital topic, we’re featuring Jason Master, Vice President of BPO Operations at HealthAxis. With a robust background in healthcare operations and a passion for innovation, Jason will share his expert insights on managing increased call volumes, tracking performance metrics, and leveraging technology to enhance call center efficiency during open enrollment.
How can health plans effectively manage increased call volumes during open enrollment while maintaining high levels of customer satisfaction?
Vice President of BPO Operations
Managing the surge in call volumes during open enrollment is a significant challenge, but it’s also an opportunity to reinforce member trust through exceptional service. To effectively handle the influx, health plans should implement a multifaceted approach focused on strategic staffing, advanced call center technology, and a strong emphasis on customer service excellence.
First, it’s crucial to have a well-prepared staffing plan in place. This means hiring additional temporary staff to manage the increased volume and investing in thorough training programs well before open enrollment begins. Agents should be fully equipped with the knowledge and tools they need to resolve member inquiries efficiently, reducing the need for call transfers and ensuring first-call resolution.
Additionally, utilizing intelligent call routing systems can significantly enhance efficiency. By directing calls to the most appropriate agents based on their expertise, health plans can minimize wait times and ensure that members receive the right answers promptly. This, coupled with self-service options such as interactive voice response (IVR) systems and online FAQs, can help deflect routine inquiries, allowing agents to focus on more complex issues.
Lastly, maintaining high levels of customer satisfaction requires a culture of empathy and active listening. Agents should be trained to handle stressful situations calmly and to communicate clearly and compassionately. Providing regular feedback and support to agents during this peak period can help maintain morale and, in turn, improve the overall member experience.
What key metrics should health plans track to measure call center performance during open enrollment, and how can these metrics be used to improve operations?
Tracking the right metrics is essential for health plans to assess call center performance and identify areas for improvement during the busy open enrollment period. The key performance indicators (KPIs) that should be monitored include:
- Service Level:
- The percentage of calls answered within a specific time frame (e.g., 80% of calls answered within 30 seconds).
- Reflects the responsiveness of the call center and impacts customer satisfaction.
- Average Hold Time (AHT)
- This is the amount of time a caller spends on hold before speaking to a representative.
- The goal is to balance efficiency with quality—short calls are not always better if they leave issues unresolved.
- Monitoring AHT alongside First Call Resolution (FCR) helps ensure that efficiency does not compromise customer satisfaction.
- Call Abandonment Rate
- Reflects the percentage of callers who hang up before speaking to an agent.
- A high abandonment rate often signals long wait times or inadequate staffing levels.
- Tracking this metric in real-time allows for necessary adjustments, such as reallocating resources or activating overflow teams, to better manage call volume and reduce wait times.
- First Call Resolution (FCR)
- Measures the percentage of calls resolved without the need for follow-up.
- A high FCR indicates that agents are well-trained and empowered to handle a variety of inquiries on the spot.
- Improving FCR can reduce overall call volume and enhance member satisfaction by addressing issues promptly.
- Customer Satisfaction Score (CSAT)
- Provides direct feedback from members about their experience.
- Regular post-call surveys offer insights into service effectiveness and help identify areas for improvement.
- Dips in CSAT can prompt immediate corrective actions to address service quality issues before they impact overall member satisfaction.
By closely monitoring these metrics, health plans can make data-driven decisions to optimize call center operations. For instance, if AHT or call abandonment rates are rising, it may indicate a need for additional training or a reevaluation of call routing strategies. Similarly, dips in CSAT can prompt immediate corrective actions to address service quality issues before they affect overall member satisfaction.
How can health plans leverage technology and automation to streamline call center operations and improve agent productivity during open enrollment?
Health Technology and automation are powerful tools that can transform call center operations, especially during the intense period of open enrollment. By integrating advanced solutions, health plans can streamline processes, reduce the burden on agents, and ultimately improve the quality of service provided to members.
One of the most impactful technologies is intelligent call routing, which uses algorithms to direct calls to the most suitable agent based on the caller’s needs and the agent’s expertise. This reduces the time spent transferring calls between departments and ensures that members receive accurate and timely assistance, leading to higher satisfaction rates.
Automation can also play a significant role in handling routine inquiries, such as account balance checks or basic plan information. By utilizing AI-driven chatbots and interactive voice response (IVR) systems, health plans can provide members with instant answers to common questions without requiring human intervention. This not only frees up agents to focus on more complex issues but also reduces wait times for members.
Workforce management tools are also crucial during open enrollment, as they allow health plans to forecast call volumes and adjust staffing levels accordingly. These tools can schedule shifts, monitor agent performance, and ensure that the call center operates at optimal efficiency throughout the enrollment period.
By leveraging these technologies, health plans can not only handle the increased demand during open enrollment but also deliver a superior member experience. The result is a more efficient operation that supports both the plan’s objectives and the needs of its members.
If you need immediate support or have questions about how HealthAxis can assist in your open enrollment readiness, connect with our experts today. We’re here to help ensure your success during this pivotal time.
