I've seen a lot mentioned about outsourcing jobs, such as claims and UM. Of course, they don't have a place for us to see exactly which functions are being shipped overseas. I was wondering of we could use this thread to make those situations known? It may help people start planning for their possible layoffs if we all knew where the deep cuts were really happening.
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Several team members have reported IT desktop support functions are being handled by an office in the Phillipines.
What used to take a day or two to resolve is now taking weeks or isnt getting resolved at all.
At least they are vastly more pleasant to deal with than the last people they outsourced to who didn't resolve our issues.. lol
I am CA LOB adjustments too - the goal is to send all of our work offshore period - the end. And they will. And then what? You still gonna go with the "it's nothing new". And hint we have too much to handle because they did 3 rounds of layoffs in 2023 alone and offshore keeps fu--ing up claims that we have to rework because they are more concerned with numbers than they are with quality. And don't get me started on the language barrier and the fact that they don't even have the resources to do their job correctly because Centene is too cheap to invest in those resources.
I'm in CA for claims (adjustments) when we have to much to handle they send ot offshore + they have thier own claims work they do
Every insurer does this - offshoring is not new...
More UM is being sent overseas.
All Medicare and Marketplace claims processing is on the table to be fully outsourced globally...governance allows it with no issue. Medicaid is trickier because some states only allow domestic TPA's for claims processing, but most TPA's offer domestic teams as well for that specific purpose.
I am in CA claims and I have been told that the goal is to offshore as much of claims as possible if not all of it with the exception of where they cannot ie - Federal/CMS and Medicaid but I am sure they will eventually find a way around that.
I'm in CA for claims (adjustments) when we have to much to handle they send ot offshore + they have thier own claims work they do
I'm aware of 3 different states for medicaid claims now being outsourced and it appears that I.T. has been as well.
Smart, I like it.
From what I know in my state and in my department, they are beginning to slowly increase the amount of claims being processed off shored. The primary plans I see this happening to are the metal level plans.
Member reimbursements as well. Being processed offshored.