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RMIS | CLAIMS MANAGEMENT & CLAIMS ADMINISTRATION 

Streamline oversight and reduce claims costs

Consolidate data, automate workflows, and improve outcomes with tools for managing and administering claims across all lines of coverage.

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Centralize your claims data and workflows to drive better outcomes

Whether your team self-administers or you’re looking to improve how you manage and report on data from TPAs and carriers, Origami Risk delivers comprehensive solutions that can be configured to meet the needs of your claims program. Improve efficiency, enhance visibility, and inform decisions that reduce your total cost of risk with automated workflows, centralized communications and documentation, and intuitive reports and dashboards.

CLAIMS MANAGEMENT OFFERINGS

Tools to improve claims oversight and outcomes

Claims Financials Tracking

Monitor reserves, payments, and financial trends to improve forecasting and reduce claims costs.

Subrogation & Recovery Tracking

Identify recovery opportunities and track subrogation efforts to maximize reimbursements and reduce net loss.

Claim Litigation Management

Centralize legal documentation and track litigation status to improve collaboration and oversight and reduce legal exposure.

Leave of Absence Management

Coordinate leave tracking with claims data to ensure compliance and streamline employee communications.

Lost Time Tracking

Monitor lost time trends and durations to support return-to-work strategies and reduce claim costs

Electronic OSHA Reporting

Automate OSHA reporting with built-in tools that simplify compliance and reduce administrative burden.

Return-to-Work Management

Support recovery and reintegration with tools that track modified duty, restrictions, and progress toward full return.

Claim Benchmarking

Compare performance across claims, adjusters, and programs to identify trends and improve outcomes.

Claim Audits

Conduct internal or external audits with configurable templates and workflows to ensure accuracy and compliance.

Adjuster Performance Analysis

Evaluate adjuster effectiveness using performance metrics to improve accountability and claim outcomes.
CLAIMS ADMINISTRATION OFFERINGS

Configurable tools for in-house claims handling

Payment Processing

Automate and track payments to ensure accuracy, timeliness, and compliance with internal and external requirements.

Reserve Management

Set and adjust reserves with audit trails and approval workflows to maintain financial accuracy and transparency.

OFAC Sanctions Search

Screen payees against Office of Foreign Assets Controls (OFAC) lists to ensure compliance with federal sanctions regulations.

1099 Production Support

Generate and manage 1099 forms for claim-related payments to support year-end tax reporting.

ISO Claims Search

Search ISO databases to identify duplicate claims and uncover potential fraud or prior incidents.

CMS-111 Reporting

Automate CMS-111 submissions to ensure compliance with Medicare reporting requirements.

Official Disability Guidelines (ODG) Integration

Access evidence-based treatment guidelines to support claim decisions and improve return-to-work outcomes.

State Forms

Generate and submit up-to-date, jurisdiction-specific forms to meet regulatory requirements across states.

Indemnity Benefit Calculations

Calculate indemnity payments with built-in formulas and rules to ensure accuracy and compliance.

Electronic Injury Reporting (EDI – FROI/SROI)

Submit First and Subsequent Reports of Injury electronically to streamline compliance and reduce delays.
OTHER RMIS SOLUTIONS

End-to-end risk management solutions

Connect data for informed insights that improve incident processing, claims and policy management, renewals activities, and more — all from a centralized risk management system.

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Measure risk investment impact

Transform your ability to measure, analyze, and report on risk costs with dynamic AI-powered calculations, limitless data ingestion options, flexible visualizations, actionable projection capabilities, and seamless integration with Allocations.

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Improve incident collection and prevention

Capture accurate incident data using flexible intake tools, automate workflows and TPA feeds, and analyze root causes to understand and prevent future occurrences.

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Unify your policy information

Centralize insurance information and connect it to claims data, enabling analysis of coverage levels, retention scenarios, and counterparty exposure while simplifying renewals and broker communication.

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Allocate costs with precision

Allocate risk management costs across the organization based on configurable formulaic models, flexible cost element selection, and seamless integration with TCOR Analytics.

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Track exposures efficiently

Manage exposure information across location hierarchies that mirror your organizational structure, automate values collection to reduce administrative workload, and forecast exposure changes to support renewal planning.

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News and insights

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Blog

How Healthcare Organizations Can Use Data to Take Control of Risk Financing 

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Press Release

American Guaranty Fund Group Selects Origami Risk’s Cloud-Native Platform to Transform Claims at Florida’s Guaranty Associations

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Blog

Trust as a Workflow: How Risk Technology Supports CANDOR in Healthcare 

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Whether you’re exploring solutions or ready to scale, our team is here to help build something great.