Client Solutions


The Industry

Innovative Solutions. Lower Costs. Better Experiences.

Is any industry coping with more headaches than healthcare? Changing government policies, empowered but often confused consumers, a complex landscape of providers, digital disruption in both service delivery and the marketplace, and unrelenting cost pressures all present serious challenges for every healthcare organization.

You need a partner you can count on. Convergys is ready, around the globe. 

  • With proven healthcare solutions that simplify complex interactions for members and providers alike, improving experiences and outcomes.
  • With deep expertise in the complexities and nuances of the healthcare environment, from limited enrollment windows to clinical services like disease management.
  • With forward-looking innovations to accelerate your digital evolution, from virtual assistants and robotic process automation (RPA) to proactive solutions for every channel, including social media.

For Health Plans, BCBS Plans, Pharmacy Benefit Managers, Retail Pharmacies, Pharmecutical Companies, and Medical Supply/Device companies, we deliver onshore, nearshore and offshore solutions in a HITRUST certified environment.

Our healthcare solutions include:

  • Member and Provider Care

    Benefits and eligibility; claims status, adjustments; government FEP; Medicare member & provider support; vision care; wellness/drug adherence; FSA/HAS/HRA; COBRA.

  • Member Acquisition and Re-Acquisition

    Licensed and non-licensed enrollments; Medicare MA, MAPD, PDP, and STARS support; healthcare exchanges; retention and acquisitions.

  • Sales and Revenue Generation

    Inbound and outbound sales and lead generation; revenue cycle management; licensed health, life, and dental insurance sales.

  • Pharmacy, PBM, and Specialty Support

    Pharmacy help desk; medication adherence; prior authorization; licensed pharmacy technicians; refile and refill status; retail to mail conversion.

  • Technical and Device Support

    Medical device application and software support.

  • Back Office

    Insurance verification; document management/header entry; data collection/scanning; payroll processing; claims research/auditing.

  • Core Clinical Services

    Concurrent, utilization, and retrospective review; disease and case management; wellness coaching.

  • Clinical Support Services

    Billing and eligibility; claim status; intake and discharge notifications; medical coding.

  • Care Coordination

    Health risk assessments; gaps in care closures; welcome/reminder calls; redeterminations.

Related Resources

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Improve Satisfaction and Outcomes

Gain the actionable insights you need to improve member and provider experiences and reduce costs with focused, data-driven analytics.

Simplify the Digital Experience with Chat

Deliver quicker, easier issue resolution by optimizing chat as part of your overall digital engagement and self-service strategy.

Contact Us

Contact Us

Please call us or complete the contact form for more information about our services/solutions for your business, or for our participation in your RFI or RFP process.

+1 800-344-3000 US
+1 513-458-1300 INT’L

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