Claims Operations & Systems Solutions

Enabling managed care organizations to develop the most effective and efficient methods to process
claims, improve overall claims accuracy, and integrate new technology systems and workflows.

A Critical Lever in Achieving Operational Excellence

Claims transactions are the foundation of the care continuum, yet healthcare organizations continue to struggle with streamlining claims operations and advancing claims configuration for optimal performance.

 

With healthcare regulations and dynamics shifting rapidly, health plans continuously explore enhancements to core platforms to reduce administrative costs, increase member & provider satisfaction, and ultimately improve the bottom line. Clearlink’s Claims Operations & Systems Solutions provide clients the tools, insight, and processes necessary to ensure its claim payment operation is functioning at peak performance and quality.

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Solutions for Enhanced Claims Processing

 

Clearlink’s Claims Operations & Systems experts empower managed care organizations through exercising their decades of industry experience and knowledge of best practices, methodologies, tools, and technologies. Clearlink’s vision is to optimize claims operations for our clients to ensure the availability of accurate and critical information, advance strategic decision making, and achieve business goals.

SYSTEM
IMPLEMENTATION
& OPTIMIZATION

Delivering customized solutions derived from proven methodologies and approaches to ensure successful new system implementations, upgrades, and optimizations.

DATA INTEGRATION
&
INTEROPERABILITY

Enabling interoperability solutions through the expertise of our seasoned leaders delivering transparency, standardization, and security.

CLAIMS
CONFIGURATION &
ADJUDICATION

Assessing and optimizing configuration architecture to accelerate claims processing while improving accuracy.

ADVANCED
DATA
ANALYTICS

Harnessing the power of data, business intelligence capabilities, and informatics to improve clinical and financial outcomes.

ADVISORY
SERVICES

Providing our clients with the expertise, capabilities, and capacity to seamlessly transition from strategy through the achievement of steady state. Clearlink delivers assessments, gap analyses, future state roadmaps, portfolio planning, and project staff augmentation as a comprehensive capable partner.

Accelerate Your Claims Operations & Systems Strategy Forward

 

Clearlink’s Opportunity Assessment is a two day, no cost evaluation of your claims operations and technology systems. Our experienced leadership will thoroughly assess your programs and processes, including tools, software, claims payments, vendor performance, quality, organizational design, and more.

 

Upon completion of the assessment, we will provide you with a list of targeted opportunities and estimated savings so you can be assured of value and be confident in your selection of Clearlink Partners to optimize your claims operations and systems strategy.

Get started with your Opportunity Assessment Here!