Get ride of back office guide page
put general information here: user access get next work, urgency, back office vidsJump to:
- User Access
- Get Next Work
- Urgency
- Case Roll-up
- Video Walkthroughs
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User Access Anchor Agent Access Agent Access
Agents can access QFD through a link in their customer service tool (CST). An agent will be assigned to a workgroup, based on their profile settings. An agent can access the user profile and view the workgroup assignment(s).
In the top right corner of the QFD screen, the agent will see a colored circle with the agent's initials. Clicking on that circle will allow the agent to access their profile. In the bottom right-hand corner of their profile, they can see what team(s) they are a part of in the QFD system. The assigned workgroup(s) will help to ensure that an agent only receives work items aligned to their skills. If you experience an issue with access, please reach out to your manager.
Get Next Work Anchor Get Next Work Get Next Work
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When an agent is ready to begin working claims within QFD, they would click on the Get Next Work button located in the top left corner of the QFD screen. When an agent clicks the button, they are served the next most urgent assignment in the work queue(s). This is based on the workgroup they are assigned. |
Urgency Anchor Urgency Urgency
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Assignments in QFD are prioritized and presented to agents based on their urgency. Assignment urgency is calculated for each claim throughout the day based on the following factors: claim age, regulation dates, recovery deadlines, claim amount, and assignment. Agents should always get the work assignments through the Get Next Work which will help ensure that the agent is working on the most critical items next. |
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Case Roll-Up Anchor Case Case
The case rollup is displayed at the top of the screen when viewing a case and provides agents with a visual indication of where the case is at in the lifecycle and what steps require action if any.
There are various icons to the left of the case steps, which indicate the action that has been taken or the action that needs to be taken to move the claim through each stage. Provided below is a legend for each of those icons.
Any items with the play or red play icon require an agent to take action to complete.
Icon | Description | Meaning |
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Green Checkmark | A step that has the green checkmark next to it means that the step has been completed. | |
Play Icon | This icon shows a strep that requires an agent to review and take action on this step. | |
Red Play Icon | Similar to the play icon, this step requires an agent to review and take action. It is red because the step is past its deadline goal. | |
Double Triangle Play Icon | This step contains the assignment selected by Get Next Work. Can either be ready (navy double triangle) or urgent (red double triangle) work. | |
Gray Clock | This icon shows steps that are pending completion by QFD. No agent action is needed for this step. | |
Yellow Triangle Attention | This icon is displayed next to the open regulation deadline for a claim in the Case Details section. |
The Case Roll-Up includes the following stages, which we go into more detail below.
Collect Stage Anchor Collect Stage Collect Stage
This stage is the intake of the claim.
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The Collect stage houses the information that we captured during claim intake. This includes:
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Enhance Stage Anchor Enhance Stage Enhance Stage
This stage prepares the disputes to be worked in the back office.
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The Enhance stage is the first point where actions are taken in the back office once the intake process is completed. This stage consists of the following steps:
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Analyze Stage Anchor Analyze Stage Analyze Stage
This stage is where the agent makes decisions about the next actions on a case.
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The Analyze stage is where the agents will take the majority of their actions within QFD. This stage can also have automation points in certain areas that will be called out in the specific flows. This stage consists of the following steps that can be taken:
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Execute Stage Anchor Execute Stage Execute Stage
This stage is where automation kicks off to make decisions.
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The Execute stage is where the actions taken on the case are a result of the analysis completed in the Analyze stage. These actions can also be completed based on automated calls to external systems. The following steps are completed through the Execute stage:
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Resolve Stage Anchor Resolve Stage Resolve Stage
The Resolve stage is the last step in the claim. This is updated to show once a claim decision has been reached. This step is automated once the resolution decision has been made.
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