Health Insurance Call Center

How to improve health insurance call center performance

The CallMiner Eureka conversation intelligence platform delivers all the tools you need to improve performance while enhancing the member experience.

Challenges for the health insurance call center

The healthcare landscape is rapidly evolving, and health insurers must work diligently to keep pace. Healthcare reform, new regulations, greater competition, and higher customer expectations mean that health plans must work harder to deliver exceptional member experiences that allow them to stay viable and competitive.

A health insurance call center is essential to this effort. With the right technology, insurance call center agents can more effectively answer questions, manage patient billing, navigate claims and coverage, and deliver exceptional patient service. Superior health insurance call center solutions can also mine the conversations between agents and members to better understand the patient’s experience and identify their needs, desires, opinions, and expectations.

CallMiner can help. With a platform that harnesses the power of conversation intelligence, CallMiner provides all the tools that health insurance call centers require for enhancing patient experiences, increasing satisfaction, and driving call center efficiency to reduce costs and improve margins.

The Forrester Wave™: Conversation Intelligence for Customer Service, Q3, 2023

The benefits of conversation intelligence

Conversation intelligence is an AI-powered technology that automates the study of voice and text-based interactions such as phone calls, chat, emails, SMS, and other communications. Using natural language processing (NLP) technology, a conversation intelligence platform analyzes interactions to understand the meaning of conversations as well as the emotion in a speaker’s voice, which can help to identify intention and the drivers of behavior.

By capturing, transcribing, analyzing, categorizing, and scoring 100% of conversations with patients, the CallMiner conversation intelligence platform can help a health insurance call center extract meaningful insights from every interaction. CallMiner can reveal deeper insight into what members want, need, and expect from their health plan and how they feel about the interaction and service they receive. Armed with this data, health insurance companies can take action to improve member experiences and increase satisfaction. CallMiner can also reveal ways in which call centers can improve efficiency and strengthen agent performance to reduce costs and improve outcomes.

Optimizing the health insurance call center with CallMiner

CallMiner is the global leader in conversation intelligence technology, providing a comprehensive solution for analyzing omnichannel customer interactions at scale. The CallMiner Eureka conversation intelligence platform analyzes interactions with customers at the deepest level, revealing areas of opportunity for driving business improvement and enhancing customer experiences.

The CallMiner Eureka platform comprises a set of solutions that enables health insurance call centers to:

• Automatically capture, transcribe, analyze, and score 100% of conversations with customers, tagging interactions with sentiment and emotion data to deliver actionable insights that drive business growth.

• Create a culture of improvement with tools that help supervisors monitor, understand, and optimize agent performance at scale. With deep visibility of agent and customer interactions, supervisors can monitor performance trends, target behavior for guidance and improvement, and identify coaching moments.

• Alert agents and supervisors to potential negative customer experiences and provide next-best actions that help improve outcomes and reduce risk of fines or legal action. CallMiner can also alert agents when indicators suggest a patient needs immediate medical attention and escalate the call to an appropriate healthcare provider.

• Securely record customer interactions with high-quality audio. CallMiner collects high-fidelity, speaker-separated audio to improve the accuracy of transcriptions.

• Visually explore conversation intelligence data with interactive presentations that allow users to connect the dots between insight and action. Easy-to-use interfaces make it simple to drill down into the detail of a single agent or customer.

• Accurately identify and remove sensitive numeric data and personally identifiable information from text interactions and transcripts of calls. Through automatic reaction, CallMiner helps protect patient data and ensure compliance with HIPAA privacy regulations.

Enhance experiences. Improve performance. Turn insights into actions.

The CallMiner Eureka conversation intelligence platform enables health insurance call centers to achieve multiple objectives.

• Enhance customer experiences. By delivering deeper insight into the needs, frustrations, and opinions of customers, CallMiner helps health insurance companies to improve experiences, eliminate obstacles, and increase member satisfaction.

• Improve agent performance. With CallMiner, health insurance call center managers can discover trends of top performers, provide automatic feedback and coaching, draft more effective scripts, and provide agents with next-best-action guidance to improve the outcomes of interactions.

• Drive business improvement. By making interactions more tailored and efficient, CallMiner can help health insurance companies to deliver on patient expectations while increasing efficiency in call routing, reducing average handle time, improving first call resolution, and strengthening performance on a wide range of metrics.

• Manage compliance across channels. CallMiner can help keep agents compliant through real-time guidance during conversations with members. Transcriptions of interactions can identify compliance issues and inform compliance coaching.

• Increase sales. By mining every conversation for customer willingness to purchase or upgrade policies, CallMiner can automatically identify upsell and cross-sell opportunities

Why customers choose CallMiner

CallMiner Eureka is the conversation intelligence technology of choice for many of the world’s leading businesses. Customers in industries such as insurance and healthcare rely on CallMiner to reveal meaningful insight from customer conversation at scale and to deliver the intelligence needed to make better business decisions.

Whether deployed in inbound contact centers for healthcare organizations or as support or sales software for health insurance companies, CallMiner provides all the tools that organizations need to navigate a quickly changing landscape in the healthcare industry. No other platform delivers more configurable solutions and deeper customer understanding for improved business outcomes. By enabling leaders in health insurance companies to connect the dots between insights and action, CallMiner helps to identify areas of opportunity to improve member experiences, drive business improvement, and achieve transformational growth.

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Frequently asked questions.

A health insurance call center is an organization or department with agents who are responsible for inbound and/or outbound communications with customers about their health plans, insurance claims, medical coverage, and other matters related to health insurance.

Conversation intelligence is an AI-driven technology for capturing, transcribing, and analyzing customer interactions across a range of communications channels. By analyzing conversations for meaning, insight, and emotion, conversation intelligence helps organizations to better understand the needs, opinions, feelings, and expectations of their customers.

A conversation intelligence platform can help healthcare call centers to mine every interaction with customers for insight into how to improve customer experiences and enhance customer satisfaction. Conversation intelligence can also reveal ways in which call center agents can manage interactions more efficiently and effectively to improve outcomes for customers and to reduce costs in the call center.


This is the number one thing we wanted; something automated to understand the patient experience in a faster and more accurate way. Before CallMiner, we were doing patient surveys and manual quality assessments, and that just doesn’t offer the same level of actionable insights.

Sabine Harrison

Contact Center Director, Kelsey-Seybold Clinic