Health Insurance & Managed Care Pod Size: 45 Specialists + 4 AI Bots

Modernizing High-Volume Prior Authorizations and Claims Adjudication Under Strict HIPAA Compliance

The Operational Bottleneck

A regional U.S. health insurance payer covering 420,000 members experienced severe prior authorization bottlenecks and an unprocessed claims backlog exceeding 38,000 files following open enrollment. Manual document verification across non-integrated EMR portals led to a 14-day turnaround time, high provider friction, and mounting regulatory penalties under state prompt-pay statutes.

The Rocket Architecture

Rocket deployed a dedicated nearshore pod of 45 HIPAA-certified medical coders and intake coordinators in Medellin, operating synchronously in U.S. Eastern and Central time zones. We engineered a proprietary Document AI OCR layer that parsed unstructured fax and PDF clinical records directly into the payer’s QNXT core adjudication system.

  • Biometric clean-desk environment with strict zero-local-storage VDI access
  • Dual-layer clinician review for escalations, peer-to-peer scheduling, and denials
  • 24/7 bilingual provider verification hotline for urgent surgical approvals
72%
Turnaround Reduction
From 14 days down to <48 hrs
99.6%
Clean Claim Accuracy
Exceeded 98% contractual SLA
$3.8M
Annual OpEx Saved
58% cost reduction vs domestic

"Rocket Multi Services did not just supply labor—they completely re-engineered our intake pipeline. Our provider grievance rates collapsed within 60 days."

VP of Healthcare Operations
Regional Health Plan (Florida & Georgia)

"Our onboarding drop-off plummeted by 42%. Rocket's fraud detection analysts caught sophisticated synthetic identity attempts that our automated filters missed entirely."

Chief Risk & Compliance Officer
Top 25 U.S. Digital Neobank
Financial Services & FinTech Pod Size: 30 Risk Analysts • 24/7 Coverage

Scaling 24/7 KYC / AML Identity Verification and Real-Time Fraud Triage for a Digital Bank

The Operational Bottleneck

A rapid-growth digital banking platform adding 60,000 monthly accounts suffered an onboarding bottleneck: 32% of applicant IDs triggered secondary manual compliance review. Customers waited up to 72 hours for account verification, producing severe drop-off rates and overwhelming their domestic customer support team.

The Rocket Architecture

We engineered a SOC 2 Type II certified 24/7 financial risk operations center. Our ACAMS-trained compliance analysts conducted real-time reviews of government credentials, proof of address, OFAC sanctions, and synthetic identity markers directly inside the client's Alloy / Jumio workflow engines.

  • Dedicated fraud analysts with average turnaround speed under 18 minutes
  • Integrated automated SAR (Suspicious Activity Report) drafting for FinCEN review
  • 100% audit trail compliance with full screen recording and dual-factor authorization
< 18 min
Avg Manual Verification
Down from 72 hours
42%
Drop-Off Reduction
Direct funnel conversion boost
$1.6M
Prevented Fraud Loss
In synthetic ID ring attacks
Healthcare Systems & RCM Pod Size: 35 AAPC Certified Coders

Overhauling Denial Management and Aging AR for a Nationwide Multi-Specialty Clinical Network

The Operational Bottleneck

A provider network of 38 ambulatory surgical and orthopedic clinics suffered from a 21.4% claim denial rate and $14.2M locked in aging Accounts Receivable (>90 days). Clinical staff were forced to spend patient care hours appealing rejected CMS-1500 and UB-04 forms with complex modifier discrepancies.

The Rocket Architecture

Rocket established a dedicated Revenue Cycle Management squad composed of AAPC-certified professional coders (CPC) and AR recovery specialists. We integrated custom claim scrubbing algorithms with their Epic and AthenaHealth EHR environments to resolve root-cause coding errors prior to clearinghouse submission.

  • Systematic 24-hour turnaround on first-pass clearinghouse rejections
  • Aggressive appeals packaging with clinical operative note cross-matching
  • Daily aging AR liquidation squads calling commercial payers (UHC, Aetna, Cigna, BCBS)
-61%
Drop in Initial Denials
From 21.4% down to 8.3%
+$5.4M
Cash Collected
Within first 120 days of go-live
28 Days
Average Days in AR
Reduced from 67 days

"Rocket unlocked five million dollars in stranded revenue that our internal billing department had written off. Their coders understand medical guidelines better than most domestic billers."

Chief Financial Officer
Orthopedic Surgical Group

"During Hurricane Idalia, our FNOL call volume surged 400%. Rocket’s team absorbed the surge seamlessly with zero dropped calls and near-zero wait times."

VP of Claims Operations
Super-Regional Property & Casualty Carrier
Property & Casualty Insurance (P&C) Pod Size: 50 Bilingual Claims Specialists

24/7 Catastrophe Surge FNOL Intake and Policy Endorsement Processing for a Tier-1 P&C Carrier

The Operational Bottleneck

A prominent U.S. property and casualty carrier experienced severe FNOL queue delays during extreme weather events, with policyholder wait times exceeding 45 minutes. Back-office teams were paralyzed processing policy change endorsements, COI issuances, and ACORD form updates across multiple agency management systems (AMS360, Applied Epic).

The Rocket Architecture

Rocket established a dedicated 24/7 catastrophe-ready nearshore intake and policy pod. Our bilingual adjusters-in-training managed high-empathy FNOL recording, emergency mitigation dispatches, and rental vehicle assignments while specialized back-office operators automated certificate tracking and endorsement rating.

  • Sub-30-second average speed to answer (ASA) even during weather surges
  • Real-time integration into Guidewire ClaimCenter and CCC ONE auto repair
  • Turnaround time on routine COI and certificate requests reduced to <2 hours
18 sec
Avg Speed of Answer
Down from 45 min queue peaks
+34 pts
Policyholder CSAT
Surged from 58% to 92%
52%
Total OpEx Savings
$2.4M saved in first year
Clean Energy & Residential Solar EPC Pod Size: 25 CAD Specialists + Permitting Coordinators

Compressing Contract-to-PTO Timeline and Eliminating Permitting Friction for a Multi-State Solar Installer

The Operational Bottleneck

A multi-state residential solar contractor operating across 7 states faced an alarming 28% customer cancellation rate. The culprit: CAD design turnaround took up to 10 days, and local building department (AHJ) permit packaging was plagued by repetitive revision requests, pushing installation dates out past 90 days.

The Rocket Architecture

Rocket deployed an end-to-end solar operational pod consisting of AutoCAD/Aurora plan set designers and dedicated AHJ permitting coordinators. We established automated permit application pipelines and introduced a proactive homeowner milestone concierge team that updated customers via SMS at every stage.

  • 24-hour SLA on complete photovoltaic engineering plan sets
  • Standardized AHJ code compliance database covering over 450 municipal jurisdictions
  • Proactive cancellation-defense outreach whenever utility interconnection was delayed
34 Days
Contract to PTO
Reduced from 88 days
< 7%
Customer Churn
Down from 28% cancellation
$0.14
OpEx Savings / Watt
Direct gross margin expansion

"Rocket shaved five weeks off our installation cycle. Our cash flow accelerated dramatically because milestone financing triggers twice as fast now."

Chief Operating Officer
Multi-State Residential EPC
The Architecture of Scale

How We Guarantee Repeatable Enterprise Outcomes

Every client case study is governed by three non-negotiable operational disciplines.

🎯

Top 1% Bilingual Talent

We do not hire gig workers. We recruit degreed professionals in Latin America with verified C1/C2 native English proficiency, rigorous domain training, and an industry-leading low attrition rate (<15%).

Cognitive AI Agent Augmentation

We augment human operators with custom OCR extraction, auto-summarization, and robotic process automation that handles routine data entry, freeing operators to resolve complex exceptions.

🛡️

Institutional Security Governance

SOC 2 Type II audit readiness, HIPAA Business Associate Agreement (BAA) execution, zero-trust network access, and clean-room physical environments engineered to protect your reputation.

Ready For Your Own Case Study?

Design Your Dedicated Nearshore Pod Today.

Schedule a confidential operational review with our enterprise architects. We will model your cost reduction, SLA commitments, and a 21-day turnkey transition plan.

Contact Executive Team
Rocket
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