HEALTHCARE SERVICES

Delivering connected care experiences in the moments that matter to improve experience, health, and growth outcomes

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Build a resilient healthcare system with a focus on care.

Deliver experiences your customers, members, and providers expect, with the human touch they need. With deep domain expertise in all nuances of healthcare and pharmaceutical services, Concentrix merges efficient, seamless, and scalable processes with an empathetic and knowledgeable workforce. We provide end-to-end services supported by strong horizontal technology and operational competencies.

With HITRUST CSF certification, we help ensure compliance with applicable laws and regulations, including strict standards for PCI and HIPAA compliance.

COVID-19 Testing & Vaccine Support

Accelerate your COVID-19 testing and vaccine readiness and response with a caring partner you can trust. We can help you serve your members, customers, and patients in this critical time with testing and vaccination program support. Our healthcare and pharmaceutical services can be rapidly deployed to help you handle the anticipated surge in testing and vaccine-related inquiries, schedule vaccination appointments, administer health plan benefits, process claims, and more.

Member Services

Make it effortless for members to resolve issues the first time they contact you. From simple benefits and eligibility questions to complex enrollment, claims, and provider search requests, our agents provide an empathetic, human experience for your members. Backed by innovative technology and cognitive analytics, we enable agents to support members with a 360 degree view of their needs to ensure issues are resolved with high satisfaction.

Provider Services

Focus on member health, experience, and satisfaction while we help to integrate disparate systems and processes across the value chain. Our network management and provider contact support services include:

  • Provider demographics load
  • Credentialing support
  • Contract load
  • Provider data accuracy
  • Eligibility & benefits calls
  • Claims calls & resolution
  • Appeals & grievances
  • VOC analytics

Health & Care Management

Manage health and care programs with ease with our holistic care coordination solutions. We help you deliver value based care with support for coverage review determinations, prior authorizations, patient services, clinical review, and case registration for workers’ compensation.

Sales & Revenue Generation

Enable members to make the right choices to support, ensure, and enhance healthy lifestyles. We integrate analytics and technology to help your members select the best healthcare coverage for their unique needs, providing experiences that increase sales conversion, retention, and long-term loyalty.

Claims Processing

Ensure timely and accurate claims processing by entrusting your claims process to us. Our back office functions provide support for the entire claim cycle, including mailroom services, data entry, adjudication, coordination of benefits (COB), repricing, and member/provider correspondence, as well as post-adjudication functions, including audits, overpayment data mining and recovery, adjustments, and payment integrity.

Technical & Device Support

Make it easy for members and patients to adapt to using the latest healthcare technology and medical devices with effortless support experiences. Our knowledgeable agents have the social, emotional, and problem-solving skills to handle members’ device-use questions with care and a sense of urgency, given the critical nature of these inquiries. We provide support to institutions as well.

Featured Insights

Personalization Powered by AI

Personalization Powered by AI

AI infused technology connects data in a way that improves efficiencies, and offers that human touch personalized experience your patients expect.

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