CONTACT CENTER

Elevating Quality Scores to 100% in Payer Contact Centers

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Perfecting Quality Performance

Quality scores represent the accuracy and effectiveness of contact center responses, as measured through audits. A high quality score indicates fewer errors and consistently positive customer interactions.

These scores directly reflect customer satisfaction and operational efficiency, as maintaining high quality ensures that callers receive consistent, accurate information in every interaction, building trust and reducing repeat inquiries.

Initial Challenge

When partnering with a large payer organization in 2024, Clarity Performance Solutions an MDI NetworX Company started with an initiative to improve quality scores within their member calls.

At first, our client was experiencing an onset of increased errors that was causing their quality score to dip. This decline highlighted potential gaps in process consistency, leading to increased risks of member dissatisfaction and potential rework for agents.

With a starting score of just 93.75%, our goal was to constantly meet or exceed the Service Level Agreement (SLA) target of 95.10% in the months to come.

Action Plan

To address the quality score fluctuation, we introduced a comprehensive quality remediation plan. This included:

Monthly team quality reviews
Live audits
Internal audits
Individual coaching

We also implemented one-on-one training refreshers for customer service representatives (CSRs) who had recurring errors.

By the first few months in, we were rolling out these interventions on a consistent basis, emphasizing the need to address identified issues immediately and provide targeted coaching to improve agent performance.

Results & Improvements

The implemented action plan began showing results in April, with quality scores rebounding to 100%. By May, scores remained high at 96.88%, with steady improvements in subsequent months. Notably, in August and September, quality scores reached 99.57% and 100%.

Comparing the first months score of 93.75% with the last months score of a perfect 100% shows a significant improvement, reflecting the effectiveness of targeted coaching and continuous quality reviews.

Improving quality scores had a direct impact on our client’s member satisfaction. By reducing errors, we minimized the need for follow-up calls, enhanced member trust, and improved the overall efficiency of their contact center operations.

Achieving 100% quality is crucial for delivering reliable and accurate information to customers, enhancing their overall experience.

Our contact center services help payer organizations maintain this high level of performance through targeted coaching, quality assurance, and continuous improvement initiatives. When quality remains consistently high, it streamlines operations to drive success for both members and the organization.

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