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.

Dedicated

EXPERT AGENTS

Global

Language Support

Client-First

Service Culture

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

Language coverage matched to your patient population, added as your needs require.

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 a strong focus on accuracy.

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: Fewer admin hours per clinician, more time with patients

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: 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: Stronger 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: Faster time-to-hire, without cutting corners

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 controls audited annually.

IMPACT: A consistently clean compliance audit track record

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. We also support related back-office needs — many healthcare clients pair this with our Logistics BPO services.

Dedicated

EXPERT AGENTS

Confidential

PATIENT DATA HANDLING

Client-First

Service Culture

Round-the-Clock

PATIENT SUPPORT

HIPAA-Trained Teams

Every agent completes HIPAA compliance training before touching a member interaction, with recurring refreshers.

Guaranteed Compliance

SOC 2 Type II controls audited annually. Fully executed BAAs on every engagement.

Uncompromising Quality

Holding the standard across every service line — patient support, claims, coding, revenue cycle, all of it.

Partnerships Built to Last

Building strategic partnerships on trust and clinical outcomes, not transactional client-vendor relationships.

Get Started

Use Healthcare BPO to Give Clinicians Their Time Back

A 30-minute call is enough to map your workflow, benchmark it against the 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 means handing off non-clinical operations — patient support, claims processing, records management, and admin coordination — to a specialist back-office team. Most healthcare providers do it to reduce admin overhead and keep internal staff focused on patient care.

Is Maximus HIPAA Compliant?

Yes. Our healthcare team operates under Business Associate Agreements where required, with HIPAA-trained agents and SOC 2 Type II controls. All agents complete compliance training before handling any health-related documentation.

Which EHR Platforms Do You Support?

We train on your specific instance during onboarding — Epic, Cerner, Athenahealth, NextGen, eClinicalWorks, and specialty platforms. We do not use generic simulators; we work inside your live system from day one.

How Fast Can You Scale a Healthcare Team?

We build dedicated teams matched to your workflow. Standard onboarding runs 3–4 weeks from scope confirmation to live agents. From there, we add capacity in small, trained waves — not mass recruitment — so quality stays consistent as you grow.

Do You Handle Multilingual Member Populations?

We deliver healthcare BPO primarily in English, with additional language coverage available depending on your patient demographic. We match language capability to your actual needs rather than claiming coverage we do not use.

What Healthcare Organizations Do You Work With?

We support private practices, allied health providers, telehealth platforms, and NDIS-registered health services. Every engagement begins with a 2-week pilot to confirm our team understands your specific compliance and workflow requirements before any long-term commitment.