Absorb seasonal surges without adding fixed headcount. This practical guide shows how to stabilize open enrollment overflow, clear claims backlogs after benefit or network changes, and fix data defects that block auto adjudication.

Inside the guide

• Three surge scenarios with step by step operating patterns

• CAPS aligned knowledge guides that reduce swivel time and rework

• Engagement options that fit TPA economics, including outcome based models

• A stand up checklist and sample runbook outline you can use immediately

Who should read this

• COO, CFO, or Head of Operations

• Directors of Claims, Member Services, or Provider Operations

• IT and EDI leaders who support enrollment, claims, and trading partner workflows