CLAIMS ADMINISTRATION
IN THE HEALTHCARE INDUSTRY

Streamline the claims process – from initial incident to final settlement.

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When professional liability and medical malpractice claims and litigation are managed separately from quality and safety, it’s virtually impossible to identify — and address — potentially compensable events before they escalate.

The Riskonnect Claims Administration solution helps reduce costs by consolidating claims information, integrating with quality and safety, and automating routine processes so you can focus on resolving even the most complex claims quickly, easily, and fairly.

Work Smarter, Not Harder

Our Claims Administration solution helps you improve workflow efficiency and outcomes by reducing clicks, automating tasks, facilitating reporting, and integrating with third parties – including ISO and Official Disability Guidelines – for faster, more informed decisions.

Take Control

Designed for organizations that manage their own claims or manage claims on behalf of others, our software enhances the stakeholder experience with real-time collaboration between internal and external parties.

All-in-One

The single platform puts everything you need right at your fingertips by seamlessly integrating people, systems, and claims data from multiple sources.

Configurable

Automated workflows offer consistency and efficiency – with built-in flexibility to deliver just what you need.

Intelligent

Advanced reporting and analytics track both individual adjuster performance and overall claims-handling efficiency.

Everything you need – and nothing you don’t.

Riskonnect’s Claims Administration software offers everything you need to get the job done not just faster, but smarter.

Audit

Logs every step of a claim to gauge progress, ensure compliance, and evaluate results – and calculates a score for individual claims, as well as for the audit.

Claims Regulatory Compliance Services

Proactively monitors current and potential regulations, manages relationships with external entities, and executes documentation to ensure regulatory compliance.

Data Transformation Services

Easily integrate with EHR, AP, HR and from more than 900 external systems used by major carriers and TPAs.

Document Management

Captures, organizes, and manages, and electronically houses all claim files and legal documents – including invoices and checks – for easy search and retrieval.

Electronic Report of Injury

Completes and sends complex electronic filings for First Report of Injury (FROI) and Subsequent Report of Injury (SROI) to keep you compliant with state workers’ compensation requirements.

Reporting & Analytics

Combines powerful analytics with intuitive and flexible report design tools to help you make better decisions around your risk, safety, and claims data.

Reserve Management

Creates and maintains indemnity benefit schedules with full reserving functionality while capturing an audit trail of all recorded changes.

Return to Work

Manages the complete return-to-work process using insights from Official Disability Guidelines and extensive collaboration capabilities to get ill or injured employees back to work quickly and safely.

Workers’ Compensation Severity Models

Identifies potentially adverse claims early in the lifecyle so you can quickly mobilize the right resources and improve outcomes all the way around.

Workflow Management

Automates routine tasks, notifications, and alerts using configurable data-entry screens, rules, and forms.

“Riskonnect really benefits us in managing a claim from beginning to end.”

Ellen Melton - Risk Informatics Administrator , Baptist Health Care Corporation
Claims administration software buyers guide

The Complete Guide to

Claims Administration Software

Whether you manage your own claims or manage claims on behalf of others, this e-book will give you the information you need to evaluate next-generation claims administration software and decide what is right for you.

See how our Claims Administration solution works.

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