claims processing
Handling submitted requests
Claims processing is the administrative work of reviewing, verifying, and settling claims—typically insurance claims for medical care, property damage, or other covered losses.
The process includes checking that claims are valid, determining coverage amounts, and authorizing payment: The hospital's claims processing department handles thousands of submissions daily.
In bureaucratic contexts, slow claims processing is a common frustration.
- deductibleOut-of-pocket threshold amount
- documentationWritten proof or instructions
- liability insuranceCoverage for harm caused
- third partyUninvolved outside entity
- fraud preventionStopping dishonest financial activity
medical bills · policyholder · automation · turnaround · dispute resolution · auditing · compliance checks · examiner · customer service · adjudication · subrogation · recordkeeping · error detection · data entry · legal compliance · pending · workflow management · back office
- insuranceinsurance, coverage, auto insurance, life insurance, home insurance
- health insurancepremium, deductible, copay, coverage, health insurance card
- Healthcare Administrationpatient care, patient records, billing, appointments, referrals
- insurance claimsadjuster, claimant, damage report, incident report, total loss
- outsourcingoutsourcing, outsource, offshore, offshoring, nearshoring
- social welfaresocial welfare, welfare state, welfare checks, social insurance, welfare benefits