Case Study: a large health care insurance plan improves call center escalation support with SQM Group

a large health care insurance plan boosts real-time escalation support to 15:1 with SQM Group

The large health care insurance plan was facing challenges in its call center, including a high volume of new agents and an overburdened internal support hotline, which hindered First Call Resolution (FCR) improvement. Managers and supervisors were frequently pulled away from their core duties to handle support queries. To address this, the customer partnered with SQM Group to overhaul their escalation and support processes.

SQM Group helped the insurer implement a revamped "Service Solutions Line" (SSL), staffed by Business Experts who provide real-time agent support and handle escalated calls. They developed a tracking tool to identify coaching opportunities and a newsletter to disseminate knowledge. This solution, guided by SQM Group, established a 15:1 agent-to-support ratio, achieved 100% escalation feedback integration, and played a significant role in the call center being certified as world-class for FCR for five consecutive years.