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CC-1564 - USA (Massachusetts) - Contact Center Services - Deadline December 16,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: CC-1564

Government Authority located in Massachusetts; USA based organization looking for expert vendor for contact center services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide contact center services to procure contact center services and the appropriate technology components needed to administer benefits, core elements of benefits administration include: intaking claims, processing and adjudicating claims, determining benefit term and amount, paying benefits, managing continuous and intermittent benefits, appeals, reporting, program integrity, fraud, audits, and customer relationship management,
- Clients with medium to high annual claims volume and with a minimum of 80,000 annual calls,
- Contact Center Services:
- The contact center will take inbound contacts from and make outbound contacts to claimants, employers, and medical providers, among other parties, via phone, email, chat, text, and mail, functions include inputting claims, troubleshooting and resolving issues during the claims process, maintaining a fraud hotline, performing document management and basic document qualifications, working collaboratively on escalations and appeals, and providing general program information,
- Claims Processing System:
- Requires a best in class claims processing system optimized for supporting an enterprise scale Paid Family and Medical Leave program across a fast, reliable, and secure cloud environment,
- The claims processing system will be the system of record for all claims, claim adjudication, leaves, eligibility determination, benefit calculation, payment advice, and claim appeals,
- Claimant Portal:
- Claims for medical leave and the various types of family leave each require a different set of qualifying information or documentation in order to determine eligibility,
- The claim intake process must guide claimants through verifying their employment and wage information, entering the information relevant to their circumstance, and uploading any supporting certification documentation,
- API Development and Integrations:
- Requires a fast, experienced, and accomplished team of API development and integration professionals to implement an integration abstraction layer that connects the claims processing system and claimant portal to existing commonwealth systems,
(2) A pre-proposal conference will be held on November 22, 2019.
(3) All the questions must be submitted no later than November 25, 2019.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Monday, 16 December, 2019

Pre-proposal Conference Date : Friday, 22 November, 2019

Question Answer Deadline : Monday, 25 November, 2019

Category : Call Center and Answering

Country : USA

State : Massachusetts

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