Health Plans & Payers

Driving business and clinical value realization
through operational efficiency, care optimization
and reimagined member and provider experiences.

Genzeon Healthcare model "fan" semicircle

How We Work with Health Plans

In the dynamic healthcare industry, financial performance is crucial for the sustainability and growth of payers. Genzeon understands the unique challenges faced by healthcare payers in managing costs, improving revenue streams, and enhancing operational efficiency.

Our tailored solutions are designed to address these challenges head-on, helping you achieve significant improvements in financial performance.

We leverage advanced analytics and data mining to identify cost-saving opportunities, streamline claims processing, and reduce administrative overhead. Our expert consultants work closely with your team to analyze data, uncover hidden patterns, and develop strategies that optimize reimbursements, minimize fraud, waste, and abuse, and enhance risk management. With Genzeon by your side, you can make informed decisions that drive profitability while ensuring regulatory compliance.


Genzeon aligns our success with yours, resulting in better care. We own outcomes not deliverables—a business model we refer to as outcomes-as-a-service (OaaS).

Health Plan Use Cases

Bill Review Automation

Automate processing of healthcare claims submitted in non-standard formats to replace existing 3rd party OCR Bill review system with a new product owned by the client.


Simplify health data exchange with business partners and data providers (HIE/EHR) by providing timely and secure access to health data in a coordinated manner for all partners.

Virtual Assistants

Evaluate potential for emerging VA technology to improve clinician satisfaction and workflows by implementing a prototype to demo and plan for potential expansion in other key workflows.

Medicare Analytics

Review current program performance, member satisfaction, and competitor benchmarking for optimal plan performance ratings and incentives.

Read more about Medicare Analytics

Physician Documentation Automation

Implement clinical conversation assistant to reduce physician fatigue by automated charting of patient–physician encounters, relieving physicians of most of their administrative burden and increasing productivity and job satisfaction.

Digital Maternity Care Management

Digitize pre-admission medical questionnaire for newly launched Maternity Care Management Program with a target go-live of 2 months.

Strategic Automation to Real Value

Recently, Becker’s Hospital Review and Genzeon leaders conducted a webinar detailing how Genzeon can help healthcare organizations avoid stalling their digital transformation progress and accelerate their value.

Watch the clip here where Kali Durgampudi, CTO of Zelis, explains how automation has addressed the need for optimization with larger financial volume with an increased shortage of talent.

Read more from our recap blog

Why Choose Genzeon?


Domain Expertise

Genzeon possesses deep domain expertise in healthcare payer operations, regulations, and market dynamics. We understand the unique challenges faced by payers and tailor our solutions to meet your specific needs.


Innovation-driven Solutions

We stay at the forefront of technological advancements, leveraging artificial intelligence, machine learning, and robotic process automation to deliver innovative solutions that drive operational excellence and improve outcomes.


Collaborative Approach

At Genzeon, we believe in forging strong partnerships with our clients. We work collaboratively with your team, ensuring a seamless integration of our solutions into your existing workflows, and provide ongoing support to ensure your success.


Security and Compliance

We prioritize data security and compliance, adhering to industry best practices and regulatory guidelines. Our robust security measures safeguard sensitive information and ensure that your operations remain HIPAA-compliant.

Regulatory Compliance

Let Genzeon help you stay compliant with ever-changing
state, federal, and industry regulations.


Meet with the Genzeon Healthcare Team

Contact us for
more information