Medicare member services support built for peak periods

Scale eligibility, enrollment, and claims support without adding fixed overhead 

Liveops helps healthcare insurers deliver fast, accurate support across the moments that matter most, especially when volumes spike and compliance expectations are high. Through our global network of experienced, HIPAA-compliant agents, we support health insurance call center workflows across voice and digital channels, helping members to get answers quickly while keeping documentation consistent and processes aligned. 

Whether your teams are expanding Medicare member services or preparing for open enrollment, Liveops helps you protect the member experience while reducing operational strain. For ongoing health insurance call center demand, we also help manage elevated inquiry volumes tied to plan changes, life events, and redeterminations. 

96%

Patient Satisfaction

300%+

Flexibility

39%

Healthcare Clients

Liveops supports health plan programs through a wide range of solutions: 

  • Eligibility/benefits inquiry handling 
  • Claims support and status updates 
  • Enrollment onboarding and education 
  • Multilingual member service  
  • CMS compliance and STARS rating support 
  • Omnichannel member engagement 
older woman with short gray hair wearing glasses, holding a phone to her ear while reading the label on a small box of medication.

Case study | Healthcare

Enhancing member and provider support for a major MCO with flexible workforce solutions 

A major managed care organization partnered with Liveops to strengthen member and provider support while staying aligned to strict service-level requirements. With precision scheduling and rapid certification, Liveops helped the plan maintain 95% QA, deploy certification in under 2 weeks, and achieve 100% SLA compliance across high-volume operations, supporting consistent delivery for Medicare member services and other member workflows. 

Read the case study

Make Medicare member services support faster, clearer, and easier to complete 

Liveops helps healthcare insurers reduce friction across high-volume Medicare member service workflows. From eligibility questions to enrollment guidance to claims updates, we support the non-clinical interactions that shape trust and help health plan members complete next steps with confidence. 

Our delivery model is built to scale quickly, maintain process consistency, and support quality and compliance requirements without slowing resolution. 

Eligibility/Benefits Inquiry Handling

  • Clear answers at first contact
    Handle eligibility and benefits questions with consistent scripting, accurate intake, and documentation-ready notes. 
  • Reduced repeat contacts
    Confirm coverage details and next steps upfront, so members do not have to re-explain the situation across channels. 
  • Clean escalations when needed
    Route exceptions and complex scenarios through structured escalation paths with complete context. 

Claims Support and Status Updates

  • Status visibility that lowers inbound volume
    Provide claims status updates, expected timelines, and next-step guidance to reduce follow-up calls. 
  • Process-aligned documentation
    Capture required claim details and maintain consistent notes that support downstream resolution. 
  • Fewer dead ends for members
    Help members understand what is needed next, whether that is additional information, corrections, or escalation. 

Enrollment Onboarding and Education

  • Guided enrollment support
    Walk members through enrollment steps, required actions, and key deadlines in plain language. 
  • Peak-season readiness
    Scale support during Open Enrollment and other predictable surges while keeping the experience consistent. 
  • Completion-focused communication
    Use reminders and follow-through workflows that help members finish what they started. 

Multilingual Member Service

  • Language access that scales
    Provide English and Spanish support, with the ability to extend multilingual coverage based on your member population. 
  • Empathy-forward communication
    Support sensitive healthcare conversations with clarity, professionalism, and care. 
  • Better outcomes across workflows
    Improve understanding and completion rates for eligibility, enrollment, and claims-related interactions. 

CMS Compliance and STARS Rating Support

  • Quality-aligned member service
    Follow documentation and process standards that support regulatory expectations and consistent member experiences across Medicare member services and broader lines of business. 
  • Support for CMS Star Ratings workflows
    Reinforce service behaviors and outreach workflows tied to CMS Star Ratings for Medicare Advantage and Part D, supporting consistent experiences across key moments within Medicare member services. 
  • Structured handling and escalation
    Identify and route compliance-sensitive scenarios quickly, with complete notes and clear handoffs. 

Omnichannel Member Engagement

  • Meet members where they are
    Support phone, chat, email, and digital messaging workflows based on your channel mix and operational needs. 
  • Consistency across touchpoints
    Maintain the same tone, policy alignment, and documentation standards across every channel. 
  • Lower channel hopping
    Reduce repeat contacts by giving members clear status updates and the right next step the first time. 
Quote What OUR clients say
Liveops offers a level of staffing flexibility we haven’t seen elsewhere. The ability to ramp support up or down—even in 30-minute intervals—is a game changer for managing dynamic volume.
Chief Operating Officer, Healthcare Client
Quote What OUR clients say
We’ve worked with lower-cost providers, but the quality wasn’t there. Liveops consistently delivers a higher caliber of service.
Director of Operations, Healthcare Client
Quote What OUR clients say
Liveops integrates seamlessly with our internal platforms, which makes it easy to stay aligned while still benefitting from their innovations.
CX Program Lead, Healthcare Client

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