Medicare BPO services built for better member experiences

Older man on phone reviewing documents, seated on couch with laptop, representing Medicare member services support.

Scale Medicare member services without adding fixed overhead 

Liveops delivers flexible Medicare BPO services that help healthcare insurers manage eligibility, enrollment, claims, and member support with greater efficiency. Through our global network of experienced agents, we help health plans navigate fluctuating demand, improve service quality, and deliver accurate, empathetic support across voice and digital channels.

Whether you’re preparing for Medicare open enrollment or managing ongoing member inquiries, our Medicare BPO solutions provide the flexibility to scale support while maintaining quality, consistency, and compliance with program requirements.

96%

Patient Satisfaction

300%+

Flexibility

39%

Healthcare Clients

Liveops supports payers & 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 
Customer service agent with headset and computer, illustrating HIPAA compliance and secure member support.

Medicare BPO support built for healthcare compliance

Liveops provides Medicare BPO services for medicare member organizations subject to HIPAA requirements. Agents within our network complete program-specific certification that includes applicable privacy and security guidelines, proper handling of protected health information, and each client’s required policies and procedures.

This helps medicare member organizations extend trusted, empathetic support while maintaining the safeguards their programs require.

  • Program-specific certification for agents
  • Guidance on handling protected health information
  • Client-defined privacy and security procedures
  • Quality monitoring and ongoing performance support

Explore Liveops’ enterprise security and compliance

Senior woman on phone engaging in Medicare member services, reviewing healthcare product box, emphasizing support and communication in health insurance.

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. Our Medicare BPO solutions combine experienced human support, operational flexibility, and technology to help members get the answers they need.

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 icon representing client testimonials for Liveops' nearshore customer service solutions in Mexico. 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 icon representing client testimonials for Liveops' nearshore customer service solutions in Mexico. 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 icon representing client testimonials for Liveops' nearshore customer service solutions in Mexico. 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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Frequently Asked Questions About Medicare BPO Services

What types of Medicare member service interactions does Liveops support?

Liveops supports non-clinical interactions including eligibility and benefits inquiries, claims status updates, enrollment onboarding and education, CMS compliance workflows, and omnichannel member engagement across voice and digital channels.

How does Liveops ensure HIPAA compliance for Medicare member programs?

Agents within the Liveops network complete program-specific certification that covers applicable privacy and security guidelines, proper handling of protected health information, and each client’s required policies and procedures.

Can Liveops scale support during Medicare open enrollment?

Yes, Liveops is built to scale quickly during open enrollment and other predictable volume surges, allowing health plans to manage elevated inquiry volumes without adding fixed overhead or compromising service consistency.

Does Liveops offer multilingual support for Medicare members?

Liveops provides English and Spanish support, with the ability to extend multilingual coverage based on the member population, helping improve understanding and completion rates across eligibility, enrollment, and claims interactions.

How does Liveops support CMS Star Ratings for Medicare Advantage plans?

Liveops reinforces service behaviors and outreach workflows tied to CMS Star Ratings for Medicare Advantage and Part D, following documentation and process standards that support regulatory expectations and consistent member experiences.

What results has Liveops delivered for Medicare and managed care organizations?

In one case study, Liveops helped a major managed care organization maintain 95% QA scores, deploy agent certification in under two weeks, and achieve 100% SLA compliance across high-volume operations.

How does Liveops reduce repeat contacts for Medicare members?

By confirming coverage details, claims status, and next steps at first contact, Liveops helps members get accurate answers without needing to re-explain their situation across multiple channels or interactions.