Health Plan Administration and Customer Care Solutions

Sure, today’s health plan administration challenges include items such as eligibility, claim status and benefit applications. But you also need to reach out and engage consumers with personalized two-way communications in this new world of healthcare where customers drive selection, pricing and choice of coverage.

To navigate the challenging new healthcare landscape, consider calling in a trusted partner to the top health plans in the industry. You can rely on our:

  • Understanding of the market
  • Clinical and consultative expertise
  • Deep experience resolving administrative challenges
  • Ability to improve your Medicare Star Rating
  • Solid customer care engagement models for prevention and wellness programs

Conduent Recognized as a Leader in Everest Group Healthcare CCO Report

Analyst and consulting firm Everest Group positioned Conduent as a leader – its highest designation – in their “Contact Center Outsourcing (CCO) Market for Healthcare Industry – Service Provider Landscape with PEAK Matrix™ Assessment 2017” report. Read the Insight to learn more and download a copy of report.

We’re a leading provider of health plan administration and customer care services. Our 10,000+ dedicated Payer agents provide services that include:

  • Benefits Explanation and Verification
  • Claim Status
  • Complaints and Appeals
  • Disease Management Programs
  • Eligibility Verification
  • Enrollment Processing Services
  • Health and Wellness Programs
  • Licensed agent customer care services
  • Missing/Invalid Information Research
  • Payment and Benefits Explanation
  • PCP Change
  • Product/Services Information
  • Referral Requests and Status
  • Satisfaction Surveys
  • Welcome Calls

We’re also a leading-edge provider of intelligent automation technology services, including:

  • Virtual Assistant – Automated voice assistance which recognizes complex, contextual, and abstract vocal inquiries
  • Machine Learning – Cognitive learning platform that analyses data to develop the intelligence it needs to understand, diagnose, and solve problems in real-time
  • Interactive Voice Response (IVR)
  • State-of-the-Art Computer Telephony Interface (CTI)
  • Customer Relationship Management (CRM)
  • Advanced Switch/Multiple Platform Integration Solutions