Careforce — CEO & Founder: AI-powered financial OS for payer/claims denial prevention and effectiveness modeling
Leveraged predictive analytics to analyze payer data and flag preventable claims denials before submission. Implemented RPA and AI-driven workflows to automate components of the claims appeal process. Created a machine-learning data model correlating clinical outcome data with reimbursement requests to quantify practitioner effectiveness. • Predictive claims denial detection • Workflow automation for claims appeals • ML correlation between clinical outcomes and reimbursement requests • Operational improvements in reimbursements and practitioner scoring