Case Study: Scaling Claims Processing Capacity for a Health TPA

Client Challenge

A health Third-Party Administrator (TPA) partnered with Acumen to support increased demand for medical claims processing. The organization relies on a highly specialized claims system and requires processors who can accurately review, analyze, and adjudicate claims in accordance with regulatory requirements, payer policies, and internal quality standards. While the client had an established internal recruiting team, they identified a need for an additional pipeline of qualified talent to maintain service level agreements (SLAs) and uphold quality benchmarks.
The initial request included launching a team of eight experienced claims processors to begin training simultaneously, with the expectation of adding additional resources over time.

Our Approach

At Acumen, we understand that not all claims experience is created equal. Differences in training, systems, and lines of business can significantly impact a candidate’s ability to succeed in a new environment.

With this in mind, we:

• Conducted a targeted market analysis to identify claims professionals aligned with the client’s systems and processes
• Focused on sourcing candidates with proven success in similar environments to minimize ramp-up time
• Leveraged our network within the insurance and healthcare ecosystem to generate a strong pipeline of qualified talent
• Collaborated closely with the client to ensure alignment on expectations throughout the process

Our strategy balanced quality and pace, enabling the client to confidently build a training class and meet their timeline.

Delivery & Outcome

• 35 candidates submitted and interviewed by the hiring manager
• 8 candidates successfully hired and onboarded into a staggered training class within one month

This approach enabled the client to efficiently evaluate talent and meet their hiring goals without compromising quality.

Long-Term Results

Following the success of the initial engagement, the client expanded their partnership with Acumen, evolving this effort into an ongoing collaboration.

Acumen is now a trusted partner supporting:

• Continued hiring of claims, customer service, operations, and HR positions

This shift reflects the client’s confidence in our delivery and candidate quality, ultimately influencing their decision to diversify away from an existing vendor.

Value Delivered

This partnership highlights Acumen’s ability to:

• Navigate the Insurance Talent Market
• Identify and attract specialized claims professionals in a competitive landscape
• Prioritize Fit and Readiness
• Deliver candidates positioned for immediate impact
• Execute with Scale and Precision
• Meet aggressive hiring timelines without sacrificing quality
• Build Lasting Partnerships
• Foster trust through consistent communication and reliable delivery