Claims Processing Services

Building Speed and Efficiency into Your Process

ExpertCallers has extensive knowledge and expertise in handling end-to-end claims processing services. We leverage this knowledge to help you build operational efficiency, reduce costs and deliver the ultimate customer satisfaction.

Your customer is looking for easy claim handling process, accurate claim settlement, and quick resolution time. While, meeting these is a challenge, meeting them at reduced costs, is a bigger need and challenge. With experienced domain experts, global delivery centers, and established processes, we boost your claims processing efficiency to meet customer expectations minus the costs involved. This arms you with the differentiation you need to stand out from the rest.

We train our agents to get a proper understanding of every claims program needs, empower them to process claims assertively, coach them to meet quality requirements, and guide them to coordinate at every level. So, when you bank on us you bank on the best to support your processing requirements.

How We Do It

  • Receive Claims
  • Eligibility Check
  • Check for Duplicate Claims
  • Benefit Determination Application
  • Verify Provider Details
  • Coding, Bundling & Diagnosis Review
  • Rules-based Edits
  • Claims Settlement
  • Claims Presentment

Claims Processing Service

  • Medicaid
  • Medicare RP
  • Superbill
  • Foreign claims
  • Dental Claims
  • RX claims
  • Enrollment Forms Processing (EFP)
  • Vision Claims
  • Invoices
  • HCFA claims 1500 / CMS1500
  • UB92 (Single / Multi / Attachment / COB)
  • UB04
  • Miscellaneous (Complex / non-standard)
  • Pends / Correspondence
Quality of Customer Service Determines the
Efficiency of Claims Processing

We are Different; Here's Why

Quality Through Efficiency

Customers want quality and we strive to provide it through operational efficiency. We have made our process efficient by banking on: centralization to reduce touchpoints, systems enhancements to streamline workflow, and data analytics to take informed decisions. We treat efficiency as an evolving process and keep ourselves busy in discovering better ways to meet quality levels.

Unbeatable Open-To-Closing Claim Ratio

A great open-to-closing claim ratio reflects on the efficiency of your business, and the capability of our processes. Our claims processing call centers have adopted the best techniques – automated systems for chosen areas, understanding of deep internal codes, fraud control technology – to minimize claims submission errors. So, we outdo our competitors in providing the best open-to-closing claim ratio.

Control Over Changed Market Conditions

If your business is prepared to deal with sudden and unanticipated changes, you get a head start in changed market conditions. Our claims processing services is flexible enough to adapt to important business shifts and help you respond appropriately to the changed conditions. This fosters continued customer relationships and sustained strong performance.

Why Outsource to Us

  • We helped a dental service provider reduce operational costs from 20 to 40 percent
  • We helped a leading insurance company increase customer retention and acquisition
  • We freed up managers of a claims processing company to focus on claims operations performance improvements
  • We transformed key processes for a health insurer to boost customer satisfaction
300+ Claims
Processing Agents
Claims Processed per Day
117.5 Claims
Processed Per Hour

What You Get

  • Claims processing cycle time cut short by half
  • Automated routine tasks for enhanced productivity
  • Specialized services and expertise across a range of areas
  • Enhanced data capture and reporting
  • Reduced reconciliation activity for stakeholders
  • Quality output at reduced costs
  • Knowledgeable resources

Contact us now to outsource claims processing bpo service.