Claims Operations

With multiple facilities across different countries, we leverage our global claims examining team to deliver increased productivity and real cost savings for our clients. We also have a robust customer-specific training and documentation process that will supplement your staff and allow us to work and handle your various time-consuming workflows. We have the ability to learn and work in your designated queues or incorporate and manage our system in any environment that best works for your business, should you need to make updates or changes.

Smart Data Solutions has significant experience in configuring adjudication systems to maximize claim payment and in assisting TPAs in plan setup and management.​

Smart Data Solutions knows how important it is to improve your turnaround times and get your various collateral processed faster. We offer multiple calling services with flexible service level agreements (SLAs) and strict quality control, removing the burden of specific timeline requirements for your business, including:

• Calling on misaddressed claims
• Calling on providers to assist with submission timelines
• Call and email campaigns to push EDI options to providers

Smart Data Solutions knows the importance of streamlining operations to meet specific goals, internal SLAs, and turnaround times. Using machine learning integrations, we have developed algorithms to aid in validating and cleaning data as it passes through QuickClaim, our proprietary workflow interface. With our customized algorithms and interfaces, developed specifically for matching, any workflow or process can be easily streamlined, saving valuable time and resources.