Healthcare Claims Processing & Adjudication Services

The Healthcare Claims Processing and Adjudication Services subcontract, issued by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on the technical processing, adjudication, and payment of Medicare Part A and Part B claims. Supporting prime contractors on Medicare Administrative Contractor projects, the scope of work includes validating provider data, verifying claim eligibility, and applying specific Medicare payment rules to manage the payment cycle for fee-for-service providers. Successful execution of this contract requires specialized expertise in Medicare regulations and CMS claims processing systems to ensure the accurate delivery of adjudicated claims and processed payments. The opportunity is categorized under NAICS code 541611, with a response deadline set for November 2, 2026.