Investigating recurring errors
Experienced agents were making recurring errors while processing genetics prior-authorization requests, despite training and extensive job aids. My investigation pointed to guidance that was difficult to apply under processing-time constraints.
I classified error records and reviewed individual root-cause narratives to identify decisions that needed clearer support. From those findings, I drafted questions to guide agents through the process.
Collaboration changed the solution
I took my initial questions to the Nurse Supervisor whose team reported the errors. Together, we refined and expanded the question set to better target the problem.
I authored the operational content: questions, answers, corrective callouts, email templates, and decision logic expressed in pseudocode. AI converted that pseudocode into the local HTML/CSS implementation.
From implementation to everyday use
I rolled out the tool in May, demonstrated it and ran one rollout refresher for each team; it is used by five teams across the 80-person line of business.
The team leads and I use the tool to coach our teams.

