Intuitive User Interface
The Orion user interface enables your staff to operate the PLEXIS platform more efficiently so that they can perform essential job functions and save costs for your organization while delivering higher-quality services.
Orion is configured for three roles in your organization:
Claims Examiner
Plexis’ claims queueing solution allows clients to better manage claim inventory and work distribution in an automated fashion.
Efficiently manage claim inventory
- Multiple Claim queues to support custom workflows
- Within the queues, criteria can be used to define parameters, for example:
- Client/Group
- Benefit plan
- Claim type (p,d.i.)
- Claim details (place of service, procedure/diagnosis codes, billed charges, etc.)
- Adjustidcation details (pend codes, claim status, calculated net pay, etc.)
- Orion automatically creates a human-readable summary of the enabled claim criteria
- Create Analysts able to work on multiple claims or anti-cherry-picking functionality
- Tasks are easily assigned to specific users or groups
- Assign individual analysts or groups of analysts to the queues
- Single location for a Claims Analyst to find the claims they need to work on
- Task functionality is available for claims within queues
- Claims analysts can identify which claims need to be worked and then work/finalize those claims within the same application.
Increasing Claims Examiner Efficiency
- Configurable claim distribution on an individual or group level
- Manual selection: Individual user selects which claims to work within their queue
- Automatic selection: Orion selects the order in which an examiner works claims
- Automatic distribution of claims to the appropriate claims analyst (or group of
analysts) - Automatically sort individual analyst queue based on configurable prioritization
- Oldest claim by receive date
- Greatest total billed charges
- Greatest total net payment
- Easy access to claim summary or claim detail information
