OAKLAND, CA–“Heroes work here.” That’s what Kelsey McAuley repeats to herself in the mirror every morning. She works a thankless job as a medical insurance claims representative. Each day, Kelsey fields numerous claims from distressed and disgruntled customers, all seeking answers from her. It’s her job to protect the company from these greedy, sick freeloaders looking to get somebody else to pay for their shit. The position is a challenging one, but little reminders, like “heroes work here,” help Kelsey remember why she got into healthcare to begin with — to make money.
I observed Kelsey on the job as she went through the motions of an average day in the life. The first call of the day, arriving at precisely nine o’clock in the morning, was a doozy. The woman on the other end of the line wasted no time diving into some cookie-cutter sob story about coverage for her ongoing chemo treatment getting declined. Kelsey’s company was unwilling to foot the bill on this woman’s six-figure charges. and she fully expected Kelsey to do something about it.
“Okay, first of all, not my problem,” Kelsey countered. She then launched into a rehearsed diatribe about the difference between medically necessary treatments and voluntary treatments. Kelsey insisted that in no way could a breast cancer diagnosis require chemotherapy treatment, and she seemed to have a point with comments like “you’ve made your bed, now lie in it.” Still, the woman disagreed wholeheartedly and the two went back and forth on it over the next two hours. Kelsey would intermittently put the woman on hold while pretending to speak to the manager. It was already an amazing performance, and she wasn’t done yet.
“Did you try Benadryl?” Kelsey offered, pivoting from gaslighting to troubleshooting to the woman’s problem. The woman was taken aback. She had never considered trying Benadryl. It had worked so many times before, so would it really be that insane if it could cure a little case of breast cancer? It was unlikely, but the woman confessed it might just be crazy enough to work. Kelsey turned to me with a smirk, silently mouthing the words “works every time.” That’s why she’s the best.
Kelsey agreed to cover a year’s worth of Benadryl for the woman. If after that one year this cancer has not been defeated, then, and only then, will they reopen the conversation about chemotherapy. A hero does work here.