Healthcare BPO Services
Give clinical teams back their time
HIPAA-compliant patient support, claims processing, and administrative operations for payers, providers, and telehealth companies. Maximus BPO delivers the back-office capacity that lets your clinicians focus on care.
4000+
EXPERT AGENTS
45+
LANGUAGES
98%
CSAT RATING
Selected for our standards. Relied on by leaders.
What we do
Healthcare BPO Services That Move Care Forward
Experienced patient support agents, coding specialists, compliance experts, and revenue cycle pros — one partner covering the operations that keep members served and claims paid.
Patient Support & Scheduling
Round-the-clock omnichannel engagement — appointment scheduling, prescription refills, care navigation, and post-visit follow-ups. Every call handled by agents trained on healthcare workflows.
Claims Processing & Follow-up
End-to-end claims workflows — from clean submission to denial management and appeals. We know Medicare, Medicaid, and commercial payer rules, and we work every claim until it’s paid.
Insurance Verification & Eligibility
Real-time eligibility checks, benefit verification, and prior authorization support — so patients arrive informed and billing teams stop chasing missing information.
Medical Records Management
Secure EHR data entry, chart abstraction, document indexing, and records requests. HIPAA-audited workflows across every major EHR platform.
Revenue Cycle Support
Registration, coding assistance, payment posting, patient billing, and A/R follow-up. Full-cycle RCM support that shortens your cash cycle.
Multilingual Member Services
Native-speaker support in 45+ languages for diverse member populations. Cultural fluency built into every script and workflow.
MORE SERVICES
Prior Authorization Support
Fast, accurate prior auth submissions and follow-ups across commercial and government payers. Trained specialists who understand payer-specific rules.
Medical Coding & Data Entry
Certified coders and data entry specialists handling ICD-10, CPT, and HCPCS workflows with error rates below 0.5%.
Care Coordination Support
Care management outreach, member engagement, appointment reminders, and post-discharge follow-up that keeps care plans on track.
Telehealth Operations Support
Virtual care coordination, tech support for digital platforms, and back-office workflows that keep telehealth programs running smoothly.
Solutions
Challenges You'll Overcome With Healthcare BPO
Healthcare admin is a treadmill — regulations shift, patient expectations climb, and margins tighten. We handle the back-office work so your clinical teams don’t have to.
Rising administrative burden
THE CHALLENGE: Non-clinical work piles up faster than teams can keep up, pulling clinicians away from actual patient care.
OUR SOLUTION: Our teams absorb the administrative load in dedicated squads that operate as a natural extension of your practice.
IMPACT: 30–40% reduction in admin hours per clinician
Paperwork and documentation load
THE CHALLENGE: Claims, medical records, prior auths, referrals — the paperwork stack grows faster than the team can process it.
OUR SOLUTION: We take over routine documentation with HIPAA-compliant workflows that speed processing without sacrificing accuracy.
IMPACT: 45% faster documentation turnaround
Patient inquiry volume
THE CHALLENGE: Rising patient volume means rising inquiry volume — and holds, missed calls, and dropped connections cost trust.
OUR SOLUTION: We extend your team with trained healthcare CX agents across phone, email, chat, and portal messaging.
IMPACT: 50% increase in first-call resolution
Staffing skilled healthcare workers
THE CHALLENGE: Hiring HIPAA-trained specialists takes months. Meanwhile, workload keeps piling up on your existing team.
OUR SOLUTION: Our teams stand up in 4 weeks with HIPAA-trained agents and BAA-signed workflows already in place.
IMPACT: 45–50% reduction in time-to-hire
HIPAA and payer compliance
THE CHALLENGE: Compliance requirements keep shifting. Medicare rules, HIPAA standards, and payer-specific policies change constantly.
OUR SOLUTION: We monitor regulatory changes and update your workflows in real time — with SOC 2 Type II and HITRUST controls audited annually.
IMPACT: 98% compliance audit pass rate
Technology
Technology Stack for Healthcare Operations
The EHR, payer, and communication platforms your existing tech stack already runs on — worked in every day by our teams.
Choose Maximus BPO
Ready to lift the back-office burden from your clinical teams?
Let’s discuss where your team is losing hours to paperwork and administrative work — and how a Maximus program could recover those hours for actual care.
Why Maximus BPO
More than a healthcare BPO provider
We’re a partner invested in the outcomes your patients need — not just the tasks on your admin queue. Every engagement is designed around your specific goals, KPIs, and compliance requirements.
4000+
EXPERT AGENTS
30+
INDUSTRY AWARDS
98%
CSAT RATING
5+
YEARS PARTNERSHIP
01
HIPAA-trained teams
Every agent completes 40+ hours of HIPAA training before touching a member interaction, with recurring refreshers.
02
Guaranteed compliance
SOC 2 Type II and HITRUST controls audited annually. Fully executed BAAs on every engagement.
03
Uncompromising quality
Holding the standard across every service line — patient support, claims, coding, revenue cycle, all of it.
04
Partnerships built to last
Building strategic partnerships on trust and clinical outcomes, not transactional client-vendor relationships.
Case Study
Real results for healthcare organizations
Decades of BPO experience have taught us what actually moves the needle for patients and payers.
HEALTHCARE & HEALTHTECH
Regional Health Plan Cuts Claims Turnaround by 42% in 90 Days
A tailored claims processing team and dedicated denial management program helped a regional health plan clear a growing backlog and lift member satisfaction across every operational metric.
42%
FASTER CLAIMS PROCESSING
98%
CSAT SCORE
100%
HIPAA COMPLIANT
$2.3M
RECOVERED COLLECTIONS
Claims Processing
Patient Support
Revenue Cycle
Get Started
Use healthcare BPO to give clinicians their time back
A 30-minute call is enough to map your workflow, benchmark it against 40+ healthcare programs we run today, and show you where the fastest wins live.
FAQ
Frequently asked questions
Questions worth asking any healthcare BPO — with straight answers.
What is healthcare BPO?
Healthcare BPO — or healthcare business process outsourcing — is when a healthcare organization hands its non-clinical operations (patient support, claims processing, coding, records management, revenue cycle) to a specialist partner. Most organizations do it to reclaim capacity for direct patient care while keeping the administrative layer running well.
Is Maximus HIPAA compliant?
Yes. Every Maximus healthcare engagement operates under a fully-executed BAA, with SOC 2 Type II and HITRUST controls audited annually. All agents complete 40+ hours of HIPAA training before touching a single member interaction.
Which EHR platforms do you support?
Every major one: Epic, Cerner, Athenahealth, NextGen, eClinicalWorks, Allscripts, and specialty platforms. Our teams train on your specific instance during onboarding — not on generic simulators — so agents are productive from day one.
How fast can you scale a healthcare team?
Our standard onboarding runs 4 weeks from signed contract to live agents. From there, we can add capacity in 15-FTE waves every two weeks, up to 500+ agents within 90 days for large ramps.
Do you handle multilingual member populations?
Yes. We currently deliver healthcare BPO in 45+ languages, with dedicated coverage for major Medicaid populations including Spanish, Mandarin, Vietnamese, Haitian Creole, and Tagalog.
What healthcare organizations do you work with?
Payers, providers, telehealth platforms, digital health startups, and third-party plan administrators. Our smallest client is a 4-agent digital health team; our largest is a 240-seat member services operation for a regional health plan.