Designing Agile and Smart Healthcare Contact Centers to Transform Claims Adjudication in Crisis Times

EasyChair Preprint 15716

Abstract

The healthcare industry has faced unprecedented challenges in the last few years, particularly with the onset of the COVID-19 pandemic, which exposed the vulnerabilities of traditional systems. One of the most critical areas affected has been claims adjudication, the process through which healthcare organizations assess and process medical claims. With mounting pressures from increased demand, operational disruptions, and a growing need for digital solutions, healthcare providers are increasingly turning to agile, smart contact center systems. These systems, powered by technologies such as Artificial Intelligence (AI), Machine Learning (ML), automation, and cloud computing, can help address inefficiencies, improve accuracy, reduce turnaround times, and enhance patient and provider satisfaction. This paper delves into the evolution of claims adjudication in healthcare and the pivotal role of intelligent and adaptable contact centers. By embracing emerging technologies, healthcare organizations can better equip themselves to navigate future crises, ensuring that claims are processed accurately and swiftly while maintaining operational resilience.

Keyphrases: Artificial Intelligence, Contact Centers, Healthcare Claims, crisis management, machine learning

@booklet{EasyChair:15716,
  author    = {Max Sterling},
  title     = {Designing Agile and Smart Healthcare Contact Centers to Transform Claims Adjudication in Crisis Times},
  howpublished = {EasyChair Preprint 15716},
  year      = {EasyChair, 2025}}