Health Insurance Carrier Achieves Multilingual CMS Compliance

[SUCCESS STORY]

Health Insurance Provider Achieves Multilingual CMS Compliance in 6 Weeks

WHAT WE DO

Insurance Support Services

Multilingual Customer Care

Customer Engagement Center

Talent Acquisition

INDUSTRY

Insurance

RESULTS

Recruited 35 Bilingual Agents Representing 7 Languages in 6 Weeks

Licensed 27 Bilingual Agents

100% CMS Secret Shopper Rating

Lack of Bilingual, Licensed Agents Threatened Looming AEP Success and CMS Compliance

[SITUATION]

With an Annual Enrollment Period looming, a major healthcare insurance provider was unable to meet the U.S. Centers for Medicare and Medicaid Services (CMS) language requirements for on-demand translation options required of service providers selling Medicare Advantage plans.

The insurance carrier’s existing vendor could not find or source translators for the five languages—Spanish, French, Cantonese, Mandarin, and Vietnamese—CMS requires servicers to provide within minutes of customer call initiation. Not only did translators need to be fluent in one of these languages, they also needed to navigate complex medical terminology and complete CMS assessments. The client turned to MarketSource to build a compliant, scalable multilingual team in time to support high AEP member call volume.

CHALLENGES


Low population of bilingual and licensed agents

Strict CMS requirements for service translation

Looming Annual Enrollment Period (AEP)

6 Weeks

to deliver a fully staffed, licensed, multilingual member care team.

KEYS TO SUCCESS


Multilingual member care team

Calculated talent acquisition

Language certification and medical terminology training

Licensing infrastructure

Talent Acquisition Specialists Recruit 35 Bilingual Member Care Agents in 6 Weeks

[SOLUTION]

Using a proven, targeted recruiting strategy, our talent acquisition specialists recruited 35 bilingual Member Care Agents—seven per required language—within six weeks. They sourced applicants who thrive in fast-paced situations and demonstrated not only the ability to adapt, but also to navigate complex, rapidly changing environments. We trained incoming agents to translate medical terminology and manage a near constant incoming call queue, seven days a week and required each agent pass a language assessment. In parallel, MarketSource enabled 27 of the 35 agents to become licensed sales agents, able to support Medicare Advantage sales and member retention—all in time for AEP.

Real-World Results

100% CMS Secret Shopper Rating

Recruited 35 Bilingual Agents Representing 7 Languages in 6 Weeks

By delivering a fully staffed, licensed, multilingual member care team in just six weeks, MarketSource helped our client meet CMS requirements and achieve a 100% secret shopper rating. A high Secret Shopper rating is key to the client’s Medicare Star Rating, which gauges compliance and patient experience—and directly impacts the client’s future Medicare reimbursement. Beyond compliance, we enabled 27 of the 35 bilingual agents to become licensed to support Medicare Advantage sales and member retention.