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When an agent is ready to begin claim work, they will 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) from the selected Assignment Group. Urgency is based on days-to-act, meaning that users are assigned claims that will reach the next regulatory deadline first.
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Case Roll-Up
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.
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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.
- Collaboration - The purpose of the collaboration step is to allow for a Verifi or Ethoca check to swiftly resolve the claim. This stage is also used for a manual review for a refund.
Provisional Credit - Research - The research step houses ARIA's investigation if enabled.
- Investigation – The purpose of the provisional credit investigation step is to review the case prior to issuing a credit to the cardholder’s account. This step is used to ensure that cases that require a provisional credit are given the right prioritization. Some programs may choose to give provisional credits automatically and some may not. If the program does not qualify for automation, a manual review would be required by the agent.
Investigation - The purpose of the investigation step is to add specific topics and information to the Investigation tool under Case Tools. This is typically handled through QFD automation. - Fees - The purpose of the fees step is to allow the agent a chance to review any fees that may need to be refunded as part of the investigation. This step will be automated and only require a manual review for exceptions. If an error is found, regulations require that the issuer must refund any fees that may have been charged to the cardholder's account around the time of the dispute.
- Interest – The purpose of the interest step is to allow the agent the chance to review an interesting bearing account and refund any interest charges that were caused by the transactions in dispute. This step would display only for claims where this is applicable.
- Disposition - The purpose of the disposition step is for the agent to determine if recovery will be attempted and, if so, what recovery reason code will be used. The agent can choose not to pursue recovery if it is determined that an error did not occur, which would result in a pay/deny decision. There are other actions available (three dots to the right of the assignment button) if more information is needed to complete the case.
- Responses – The purpose of the responses step is to alert the investigating agent that there is information from the cardholder that needs to be reviewed. This step will require a manual review by the agent.
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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.
Video Walkthroughs
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Multimedia