Compliance company sees dramatic rise in claim form quality & speed


Global Compliance Company Sees Dramatic Rise in Claim Form Quality & Speed

A global governance, risk, and compliance company needed an outsourced BPO that could take over data entry, improve quality, and speed up form completions for claims submitted by its more than 500 end-user clients.

A significant problem was inconsistency in the way claims were submitted, making it difficult for agents to gather pertinent information easily, resulting in missing form fields, reduced quality, and fewer forms completed per hour.

Even worse, the process was handled manually and flowed through multiple stages and personnel before reaching the agent to key in the data. The company also lacked a forecasting model to ensure enough agents were available during busy periods.

Service Level Agreement

The client’s SLA targeted four main areas:


Solving these problems to meet SLA requirements necessitated multiple solutions:

Real-time Guidance. Due to the variety of claim forms and types of input, we designed a solution to provide real-time guidance and tips to agents regarding less common, more complex claim types.

LMS Questions Queue. The operations team created a questions queue in the knowledge base of our learning management system where team leader and agents could contribute commonly-asked questions and examples to help peers.

Customized Training. We modified the training and nesting process to give agents more experience managing different forms and inputs. We also conducted quality assurance 100% of the time through nesting to provide relevant feedback and catch errors, which resulted in a quality increase.

Quality Scoring Automation. We built a custom tool to automate the quality scoring process, dramatically reducing the amount of time QA staff members needed to compile scores and get analytics.

Workflow Management. We took over most workflow management from the client, resulting in increased efficiency, improved quality, and a higher number of claims processed per hour.

Agent Forecasting. We created a forecasting model based on historical data to increase efficiencies and improve forecasting models.

Other Outcomes

Due to our success, the client decided to run a pilot program with a 30-minute turnaround time SLA and added an inbound voice program to provide 24/7 bilingual support.

To learn how Transparent BPO can deliver the same results to your company, contact us via email or call us at 1-800-276-5140. A member of our friendly sales staff will reach out to answer your questions.