File Review Management Platform
AI-driven fraud detection and file review for intelligence.
The Challenge for KBS Intelligence
KBS Intelligence needed a better way to identify and manage off-track claims early in the review process. Existing workflows lacked consistency, making it difficult to maintain quality across reviews and provide clear follow-up actions to investigators. Visibility was limited across teams, reducing overall oversight. As claim volumes increased, it became harder to track performance, manage SLAs, and ensure compliance with regulatory standards.
The Solution
iMSX delivered a file review management platform that enables insurers to review claims in real time against defined rules and standards. The platform provides a structured environment to assess claims by time period, team, and assessor, improving consistency and oversight across the review process. It also supports SLA tracking and compliance requirements, giving insurers clearer visibility and control when managing complex claims and reducing the risk of fraud.
Project Overview
- Qualitative claims scoring
- Comprehensive regulatory compliance tracking
- Improved operational efficiency