A day in the life of a Service Representative (SR) Becky has been an SR for a Health Insurance company for almost two years now. She has an active job, and she interacts with Sales, Marketing, Advisers, Clients, Plan Setup specialists, Plan member Administrations, Under Writings, and many other groups. Her day-to-day responsibilities include: • Providing client education during site visits. • Completing reporting requests. • Responding to service inquiries and escalations. • Processing policy adjustment requests. In general, she spends half of her time fielding service issues. If we set up New Plan correctly the first time, Becky thinks she could spend significantly less time on service issues. When she is on a site visit for several days, she worries that an urgent service issue may arise from another client. She cannot immediately respond about the impact on that client's customer experience. She also thinks the process for making plan adjustments is not consistent. Sometimes the Sales negotiates with the Client and/or Adviser and sends her an email with the back and forth of the conversation. She must read the long email thread to understand what the policy adjustment request is asking for. She thinks this may lead to plan setup errors. Often, she needs to go back to the Salesperson with questions. This can be timeconsuming as Salespeople are very busy traveling while making sales and they don't always respond promptly to email or phone calls. Sometimes the Adviser or Client contacts her directly, by-passing the Sales and she gathers their requirements directly. Collecting the request details is followed by logging the Policy Adjustment request in AdjustMe - the company's proprietary system. Other tasks may also be required that are also inconsistent: some Sales representatives expect SRs to clarify rates with Underwriter where other Salespeople do it themselves; Statehall, another proprietary software, is used to communicate with Underwriter for middle-tier mid-size clients but not used for large Corporate Clients (a standardized email is used instead). Becky thinks her role is not well defined, and there are overlaps with roles within Provincial Group Offices. Although she thinks AdjustMe serves the function of being a consistent requirement gathering tool, it has its issues: there are too many templates in AdjustMe, and it is sometimes difficult to determine which one to use; there are too many fields within each template and sometimes she can't find the right field and uses free form text to enter the requirements. Becky thinks the free-form text is a source of error as this allows for interpretation by Plan Setup Specialists. When the Policy Adjustment is complete, Becky makes a document compare as a means of Quality Control. She knows that she is not expected to do QC, but she does what she thinks is good for her client. She is aware that not all her peers do QC. Her final actions for Policy adjustments are to communicate to the client that the Adjustment work is done and send them the booklet, contract and Adjustment notice. Becky is aware that the process for the SR role is different as Plan setup team contacts the Client and/or Adviser directly when New Policy work is complete. Becky feels her role needs to be well defined and the process needs to be evaluated to successfully meet our client needs, improve quality and reduce Turn Around Time(TAT).

 

question-1- Where do we have opportunity to standardize the process? Explain your steps

Answer rating: 100% (QA)

Opportunities to Standardize the Process for Service Representative SR Role 1 Policy Adjustment Requests Handling Standardize the process for policy a... View the full answer