Administrative Processing & Front-End Support
- Digital Intake & Document Processing
- Claims Handling & Adjudication Support
- Plan Configuration & Benefits Setup
- Premium Collection & Billing Management
- Provider Information Management
- Member Eligibility & Enrollment Administration
- Appeals & Complaints Resolution
- Multi-Channel Member Support
Revenue Protection & Quality Assurance
- Eligibility Checks & Benefits Coordination
- Fraud, Waste & Abuse (FWA) Monitoring
- Overpayment Recovery Services
- Performance Metrics – Star Rating Optimization