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Company focus

Highmark

What factors are contributing to the increased call wait times for Highmark's customer service line over the last month?

Prepared by NextSprints

15 mins
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Problem-Solving Data Analysis Strategic Thinking Healthcare Insurance Customer Service Data Analysis Root Cause Analysis Customer Service Process Optimization Healthcare
Product Management Root Cause Analysis Question: Analyzing customer service call wait times for a health insurance company

Introduction

Increased call wait times for Highmark's customer service line over the last month represent a critical issue that demands immediate attention. This problem not only impacts customer satisfaction but also has potential ripple effects on operational efficiency and overall business performance. To address this challenge, I'll employ a systematic approach to identify, validate, and resolve the root cause while considering both short-term fixes and long-term strategic implications.

Framework overview

This analysis follows a structured approach covering issue identification, hypothesis generation, validation, and solution development.

Step 1

Clarifying Questions (3 minutes)

  • Looking at the timing, I'm thinking there might be a seasonal factor at play. Has there been a similar increase in call wait times during this period in previous years?

Why it matters: Seasonal patterns could indicate a predictable surge in demand rather than an underlying issue. Expected answer: No significant seasonal pattern observed in previous years. Impact on approach: If seasonal, we'd focus on capacity planning; if not, we'd investigate recent changes or issues.

  • Considering potential system changes, have there been any recent updates to the call routing system or customer service software?

Why it matters: Recent changes could be directly impacting call handling efficiency. Expected answer: A minor update was implemented two weeks ago. Impact on approach: If yes, we'd prioritize investigating the impact of this change; if no, we'd look at other factors.

  • Thinking about staffing, has there been any significant change in the number of customer service representatives or their schedules in the past month?

Why it matters: Staffing changes could directly affect call wait times. Expected answer: No major changes in staffing levels or schedules. Impact on approach: If staffing has changed, we'd focus on workforce management; if not, we'd look at other operational factors.

  • Considering customer behavior, have you noticed any shift in the types of inquiries or issues customers are calling about?

Why it matters: Changes in call complexity or topic could impact handling time and queue length. Expected answer: There's been an increase in calls related to a new product feature. Impact on approach: If call types have changed, we'd investigate the root cause of these new inquiries; if not, we'd focus on overall volume and efficiency.

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NextSprints

Updated Jan 22, 2025