Case Study

Helping a 20+ year customer overcome an appeals and grievance backlog

Helping a 20+ year customer overcome an appeals and grievance backlog

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A national healthcare payer faced over 3,200 backlogged appeals after two vendors failed to meet CMS requirements, putting its Medicare Advantage STARS rating and URAC accreditation at risk. With the year-end deadline looming, the payer turned to Conduent, a trusted partner of more than 20 years. Conduent rapidly validated case files, compiled IRE packets, and resolved the backlog in under 30 days, exceeding expectations and earning a performance bonus. Impressed with the seamless execution, the client awarded Conduent full responsibility for all appeals and grievances, now supported by over 100 onshore and offshore staff, ensuring compliance and continuity.

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