ABOUT US
ABOUT US
SiriusShield LLC is a Wyoming registered, healthcare BPO company combining remote first efficiency with experienced on-ground oversight. We support U.S. based health insurance companies, TPAs, utilization management organizations, and disease management programs with end-to-end administrative operations built for precision, compliance, and care.
Our services don’t just manage the paperwork they power the process behind access to care.
We help health plans run smoother, smarter, and more securely.
All services are delivered through HIPAA, URAC, and NCQA compliant workflows, designed by experts and monitored by performance metrics at every stage.
SERVICES
Preauthorization
We streamline the preauthorization process with speed and precision. Our medically trained team applies industry standard guidelines and payer protocols to deliver approvals that are accurate, compliant, and audit ready.
Claims Adjudication and Reconciliation
Disease Management
Utilization Review & Management
Our Value Proposition
Our Value Proposition
Compliance Without Compromise
Every service is built on HIPAA, URAC, and NCQA aligned protocols to protect sensitive health data and meet accreditation standards.
Deep Alignment in U.S. Healthcare
From procedures for claims and utilization to compliance and paperwork requirements, our staff is aware of the intricacies of the healthcare systems in the United States.
High-quality, cost effective delivery
that can be scaled with assurance. We provide value around the clock by fusing professional labor with operational excellence.
Human Driven. Technology Supported
Smart platforms enhance, not replace, the judgment of trained professionals ensuring both accuracy and care.
Faster Turnaround. Fewer Errors
We help accelerate access to care while maintaining data accuracy, policy alignment, and compliance benchmarks.
End-to-End Service Coverage
From preauthorization to claims reconciliation, every step is integrated, traceable, and monitored.
Customizable to Your Operations
Our workflows adapt to your systems, rules, and team preferences, with onboarding support and operational alignment.
Clinical and Operational Synergy
Clinical reviewers and operational staff work hand in hand to ensure smooth, compliant outcomes across every client touchpoint
URAC & NCQA Operational Integration
Our procedures are designed to meet and support ongoing accreditation goals covering timeliness, documentation quality, decision rationale, and review consistency.