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I've worked at a writing center where we used Skype as a synchronized option. The designated Webcam tutor would upload the paper into a Google Doc, send an email with the share link, and then during the time of the appointment, both tutor and student would work in the Google Doc while video chatting about the paper. We used MyWCOnline, and the student was able to upload the MS Word Doc there for the tutor to copy and paste.
We would have the student give us their username in the form they had to fill out when making an appointment. The tutor would then initiate the skype call and proceed from there.