M-CARES ABOUT YOU
M-CARE staff on the frontlines of customer service
With more than 220,000 members from nearly 1,700 contracted employers, daily life as a customer service representative in M-CARE's Member Services Department is anything but boring.
On any given day, representatives take 50 or more phone calls each. The inquiries range from health care providers verifying patient coverage to members confused about benefits. Some requests are simple and others are complex, but through it all, M-CARE representatives provide excellent service combining professionalism, pride and compassion.
"The job is something like that of a guidance counselor," says Janeane Cato, a member of the newest crop of M-CARE customer service representatives hired in August. "I help people under-stand and I answer their questions-sometimes as a counselor or coach, but also as a mediator between providers and customers."
While Cato is relatively new to M-CARE, her skills were honed during her years working in health insurance customer service and from the intensive training she received when she became an M-CARE employee.
"Our training program is set up to ensure that everyone has the tools they need to address the variety of calls we get," says Andrea Dew, customer service supervisor. "We take great pride in our work and provide continual feedback to our CSRs in order to maintain the highest quality of service we can."
Because M-CARE administers several health plan products ranging from its HMO to government-sponsored plans like M-CAID, representatives are trained in three phases: benefits and basic member service functions such as changing a primary care physician and getting a new identification card; analyzing claims payment and authorization entry; and learning the details of M-CARE's Preferred Provider Organization plan.
"Quality audits consistently show we are meeting our call and documentation goals at 98 percent of target or better," says supervisor Colleen Davis. And this level of achievement does not go unnoticed, as demonstrated by M-CARE's continued Excellent Accreditation status by the National Committee for Quality Assurance.
Member Services employs 48 people in all, 38 of whom are dedicated to answering incoming phone calls or supporting those who do. Member Services manages 10 phone options available through the customer service line, with call volumes averaging 25,000 to 30,000 per month. |
