This Government Contract opportunity from Nevada was posted on August 23, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Healthcare Claims Processing and Adjudication

Closed

State & Local

Submission Closed10/22/2024, 12:00:00 AM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

Active Opportunities Like This One

NAICS: 561422

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SLED

Outbound Calling & Proactive OutreachThis subcontract opportunity with the Oklahoma Insurance Department involves performing proactive outbound calling campaigns to support prime contractors on State-Based Exchange Contact Center projects. The selected provider will execute outreach for Marketplace initiatives and consumer reminders utilizing campaign management software and outbound dialers. The scope of work requires strict adherence to TCPA compliance and the delivery of comprehensive contact rate reporting upon the completion of outreach campaigns. Interested parties should note the response deadline of November 19, 2026, for this project categorized under NAICS code 561422.

Oklahoma Insurance Department

POSTED

DEADLINE

Workforce Staffing & Operational ManagementThis subcontract for the Oklahoma Insurance Department focuses on Workforce Staffing and Operational Management to support State-Based Exchange Contact Center projects. The selected provider will be responsible for the end-to-end management of the customer service representative workforce, including recruiting, onboarding, training, and ongoing management. Key operational requirements include utilizing workforce management and quality monitoring tools for forecasting and scheduling to ensure a fully staffed environment that consistently meets defined service level agreements. Due to the nature of the work, the contractor must possess specific experience in healthcare or Marketplace programs to effectively scale staffing levels during seasonal peaks. Interested parties should note that the response deadline for this opportunity is November 19, 2026.

Oklahoma Insurance Department

POSTED

DEADLINE

RFP for State Based Exchange Contact Center

Solicitation # EV00000990

The Oklahoma Insurance Department, through the Office of Management and Enterprise Services, is soliciting proposals to establish a State Based Exchange Contact Center. This center will serve as a centralized hub for Marketplace-related consumer assistance, providing frontline support, specialized operational issue resolution, and inbound mail and document processing. The contract includes an initial term ending December 31, 2027, with four optional one-year renewals extending through December 31, 2031. Award selection is based on best value, evaluating a combination of technical and cost factors after a pass/fail assessment of mandatory qualifications. The selected supplier must adhere to rigorous security and compliance standards, including MARS-E / ARC-AMPE compliance, annual SOC 2 Type II certifications, and adherence to ADA and WCAG accessibility standards. Key operational requirements include the designation of a Security Officer and the implementation of industry-standard physical security for document handling. Pricing must be submitted via a specific cost proposal form, with separate pricing for language access services and optional capabilities such as AI-enabled interactions and outbound calling. All travel expenses must be included in the total bid price, and the state is exempt from state sales, use, and excise taxes.

Oklahoma Insurance Department

POSTED

DEADLINE

Payee Enrollment and Digital Literacy SupportThis subcontract for the New York State Insurance Fund focuses on managing payee enrollment and providing digital literacy support for prime contractors. The selected provider will be responsible for developing enrollment workflows, creating instructional materials, and operating a help desk to assist non-technical users. To ensure successful user adoption, the project will utilize CRM and ticketing systems, and all digital deliverables must strictly adhere to ADA compliance standards. The primary objective is to establish a fully enrolled payee base and a functional support mechanism for end users. Interested parties should note that the response deadline is November 18, 2026, and the project falls under NAICS code 561422.

POSTED

DEADLINE

Contact Center Operational ManagementThe Contact Center Operational Management subcontract, issued by the Navsup Flt Logistics Ctr Norfolk under the Department of Defense, focuses on providing management, staffing, and quality oversight for prime contractors supporting Department of the Navy contact center projects. The scope of work includes managing personnel schedules, monitoring performance metrics, and ensuring strict adherence to the Performance Work Statement, specifically regarding the operational oversight of the HRBCC. This 8(a) set-aside opportunity requires a provider with proven experience in high-volume government contact centers and mandatory DCSA/NISS Facilities Clearance. Key deliverables include the production of management reports and comprehensive staffing plans. The work is to be performed in Portsmouth, Virginia, with a response deadline set for November 2, 2027.

Navsup Flt Logistics Ctr Norfolk

POSTED

DEADLINE

Customer Support & Eligibility Call CenterThis subcontract opportunity with GRTC involves providing comprehensive call center operations to support mobility network projects. The selected provider will be responsible for managing customer support, handling reservation intake, and performing eligibility verification for CARE Plus and CARE On-Demand services. Key operational tasks include managing customer inquiries and logging trips using IVR and CRM systems to ensure efficient service delivery. Due to the nature of the eligibility verification process, the contractor must maintain strict HIPAA compliance when handling medical data. The primary deliverables include managed call center operations and the provision of verified eligibility logs. Interested parties should note the response deadline of November 10, 2026, for this project categorized under NAICS code 561422.

POSTED

DEADLINE

Solicitation # N69199HRBCCFY272

The Department of the Navy (DON) is seeking a contractor to establish and operate the Civilian Human Resources Benefits Contact Center (HRBCC), a dedicated single-service center providing technical guidance and support to current, separated, and prospective Navy civilian employees worldwide. This Firm-Fixed-Price commercial contract, set aside for 8(a) small businesses under NAICS 561422, requires the provision of all personnel and management necessary to advise employees on federal benefit programs, including FEHB, FEGLI, TSP, FEDVIP, FSAFEDS, and FLTCIP, as well as retirement support via the Online Retirement Application. The center will operate Monday through Friday from 7:30 AM to 7:30 PM ET, with extended hours during the final three business days of open season. Key personnel requirements include a Contact Center Manager, Lead Functional Assistant, and Computer Specialist, with strict limitations on substitutions during the first 120 days of performance. The contractor must adhere to rigorous security and compliance standards, including DFARS 252.204-7012 for safeguarding Controlled Unclassified Information, providing a secure document upload portal, and ensuring ADA compliance through toll-free TTY/TDD capabilities. Performance will be measured via a Quality Assurance Surveillance Plan (QASP) utilizing AI-assisted scoring for 100% of inbound calls. Interested respondents must provide capability statements, relevant past performance from the last five years, and verification of their facilities clearance level or DCSA NISS status.

Navsup Flt Logistics Ctr Norfolk

POSTED

DEADLINE

Contact Center and Outreach ServicesThe Contact Center and Outreach Services subcontract, issued by the Department of Homeland Security under the Mitigation SECTION(MIT60), focuses on providing customer care and stakeholder engagement for prime contractors working on FEMA NFIP projects. Based in Washington, the scope of work involves operating a contact center utilizing CRM and telephony systems, managing stakeholder communications, and executing public outreach programs. The contractor is responsible for delivering managed contact center operations and detailed outreach campaign reports. Due to the nature of the data involved, strict adherence to PII and Privacy Act compliance is required for the handling of sensitive information. Interested parties should note that the response deadline for this opportunity is December 10, 2026, and the work falls under NAICS code 561422.

Mitigation SECTION(MIT60)

POSTED

DEADLINE

Member Support Call Center ServicesThis subcontract opportunity is for Member Support Call Center Services supporting prime contractors for the Texas Department of State Health Services HIV medication programs. The selected provider will be responsible for managing inquiries related to program eligibility, medication costs, and payment status. Key deliverables include the provision of comprehensive member support services and the maintenance of detailed call logs and performance metrics. To ensure operational security and regulatory adherence, the contractor must maintain strict HIPAA compliance and follow all established Data Use Agreements. Technical requirements include the utilization of CRM and telephony systems to manage communications effectively. This opportunity is categorized under NAICS code 561422, with a response deadline set for November 19, 2026.

Department of State Health Services

POSTED

DEADLINE

HHS Employee Service Center Call Center OperationsThe HHS Employee Service Center Call Center Operations is a subcontract for the Texas Health and Human Services Commission to operate a branded customer service center. The provider will deliver first-tier support for payroll, HR, and leave inquiries, operating Monday through Friday from 7:00 AM to 7:00 PM CT. The scope of work includes managing call center operations and employee support while utilizing CRM, IVR, and telephony systems to route complex issues to HR specialists. The contractor must adhere to strict Service Level Agreements regarding response times to ensure efficient service delivery. This opportunity falls under NAICS code 561422, with a response deadline set for November 30, 2026.

Health and Human Services Commission

POSTED

DEADLINE

Bilingual After-Hours Answering & Dispatch ServicesThis subcontract for Bilingual After-Hours Answering and Dispatch Services supports prime contractors on municipal projects for the Florida Water Distribution agency. The selected provider will be responsible for professional call handling, obtaining caller information, and dispatching responders according to City direction. To ensure accessibility and compliance, the contractor must utilize Telecommunications Relay Service and IP-relay systems and provide itemized call logs upon completion of services. Eligible vendors must hold a valid Florida business license and employ operators fluent in both English and Spanish. The opportunity is categorized under NAICS code 561422, with a response deadline set for October 30, 2026.

POSTED

DEADLINE

Banking Customer Service Support ServicesThis subcontract for Banking Customer Service Support Services provides specialized customer service capabilities for prime contractors working on State University of New York Stony Brook banking projects. The scope of work includes managing university-specific banking inquiries, troubleshooting account issues, and maintaining service protocols through the use of secure communication portals and CRM software. The primary objective is to deliver ongoing support and enhance service capability metrics. Compliance is a critical component of the contract, requiring strict adherence to New York State Banking Laws and the completion of GLBA privacy training. Interested parties should note that the response deadline is December 8, 2026, and the project falls under NAICS code 561422.

State University of New York

POSTED

7 days ago

DEADLINE

in about 1 month

AI Contract Overview

The Healthcare Claims Processing and Adjudication subcontract, issued by the State of Nevada, focuses on the professional processing and adjudication of medical, pharmacy, and behavioral health claims. The primary objective is to ensure all claims are handled in strict compliance with established contract terms and applicable regulatory requirements. This opportunity was posted on August 23, 2024, with a response deadline set for October 22, 2024. Classified under NAICS code 561422, the project is managed through the Nevada state procurement system for qualified subcontractors capable of managing complex healthcare claims workflows.