Eliminate Healthcare Claims Processing Inefficiencies — With Speed , Precision & Digital Intelligence
Healthcare claims processing is becoming more complex, putting financial stability at risk. Despite being vital to seamless payer operations, claims processing continues to be one of the most resource-intensive and error-prone processes. But, payers have an opportunity to optimize costs and improve turnaround times, accuracy, and member experience by leveraging new-age technologies including AI, automation, and analytics.
Sutherland’s AI-enabled Claims Administration solutions are built to resolve the core inefficiencies in healthcare claims processing—from intake through adjudication, adjustment, and resolution. Whether you are dealing with processing of high-volume medical claims, dental claims, high-dollar pharmacy claims cases, or anything in between, we help you move from rework and exceptions to clarity and control. Our custom healthcare claims solutions simplify complexity and unlock productivity with speed-all without disrupting your existing infrastructure.
Redefining Healthcare Claims Performance
With 30+ years of healthcare expertise, 5,000+ professionals, and 20+ digital healthcare platforms, we know what it takes to transform claims operations. We help healthcare payers uncover “easy wins” by automating claims workflows, enhancing claims data visibility, and organizing skill-based teams for specific claims types. Sutherland ensures faster deployment of intelligent automation across your claims lifecycle—so you can deliver better outcomes for members, providers, and your organization. Here’s the impact we deliver:
Higher intake digitization
Higher automation identification
Productivity gains
Financial accuracy
Reduction in processing times
Improvement in provider satisfaction
Comprehensive Solutions Across the Healthcare Claims Journey
Unlock scalable and compliant healthcare claims solutions – powered by Sutherland’s integrated global delivery model, across the full claims lifecycle.
Claims Intake & Triage
Seamlessly digitize and route claims for faster throughput
- Mail Room Services
- Phone Intake
- Sorting
- Indexing
- Triage
- Claims Set up
Claims Adjudication
Claims Review & Redetermination
Claims Adjustment
Payment Integrity
Claims Automation & Analytics
Ready to Transform Your Healthcare Claims Process?
Smart Technologies Driving Smarter Claims
At the core of our healthcare claims solution is Sutherland’s SmartClaims Automation suite—a modular platform that integrates seamlessly with your ecosystem. Some of its components that can be implemented as supporting solutions include:
NLP-powered document processing solution to boost data extraction from forms and images
Extract.AITrack and manage claims inventory digitally with precision
Digitally manage quality assurance workflows
Drive RPA and AI-based hyperautomation
Robility.AIUnlock end-to-end claims data visibility & insights for smarter decision-making
SmartHealthAnalyticsmanage datasets across your claims landscape
Smart Health ConnectAI-powered knowledge management engine for smarter agent assistance
HelpTreeDetect process bottlenecks and reveal automation opportunities