Replacing spreadsheets and shared folders with a unified, contract-linked recovery platform
The Challenge
A B2B partner needed a unified platform to modernize and scale their Zero-Balance Audit and Recovery operations. Their existing workflow leaned heavily on spreadsheets filled with complex contract formulas, an approach that was fragile, inconsistent, and hard to maintain.
They were managing hundreds of thousands of accounts, yet had no intelligent prioritization to focus staff on the claims most likely to yield recoveries. Deficiency tracking was minimal, escalation paths were unclear, and daily work distribution lacked structure.
Making it worse, payer contracts were only available as scanned documents on a network share. The files were poorly organized and not linked to individual claims. Staff had to repeatedly search through folders by client, payer, and effective date, which slowed productivity and increased error risk.
The partner needed a solution that would bring all Zero-Balance workflows together, surface high-opportunity accounts, and put every document, contract, and action point right at the associate’s fingertips.
The Solution
Naviquis deployed a unified operational platform, consolidating users, workflows, adjudication intelligence, and client collaboration into one integrated system.
Integration with adjudication system
- The adjudication engine ranked accounts by their recovery potential
- Insights on underpayments and appeal opportunities were fed directly into the platform
- Claims were automatically prioritized and distributed to staff based on business rules, payer type, and complexity
Electronic forms automation
- All outreach templates, appeal forms, and payer-specific documents were digitized
- The system generated letters, packets, and follow-up materials automatically, or let associates trigger them manually with a single action
- Eliminated manual packet assembly and sharply reduced administrative time
Workflow management and contract linking
- Every step in the appeal process, from issue identification and documentation gathering to appeal packet creation and submission, was fully tracked
- Work was assigned automatically, keeping caseloads balanced and production consistent
- A smart contract library linked the correct payer contract to each claim, removing manual searching and reducing errors tied to misinterpreted terms
Impact and Results
Operational efficiency
- Replaced spreadsheets and shared folders with a structured, governed platform
- Staff now access everything, including contracts, forms, adjudication intelligence, and prior actions, directly within the workflow
- Major reduction in time spent searching for documents or re-validating contract terms
Higher yield from zero-balance accounts
- Intelligent prioritization surfaced the accounts most likely to generate recoveries
- Automated outreach and standardized packet creation improved quality and turnaround time
- More consistent, timely appeals led to measurable increases in recovered dollars
Greater transparency and control
- Supervisors gained real-time visibility into progress, workload, and bottlenecks
- Associates received clear task lists with all deficiencies and requirements pre-identified
Reduced training burden
- The platform embedded contract rules and payer logic within the workflow, removing the need for tribal knowledge concentrated in a few specialists
The bottom line: Naviquis turned a manual, spreadsheet-driven process into a high-velocity Zero-Balance recovery operation, with structured workflows, instant contract access, automated documentation, and data-driven prioritization that lifted productivity and financial performance.
Ready to modernize your Zero-Balance recovery operation?
Connect with our team to discuss how Naviquis can unify your workflows, contracts, and adjudication intelligence into one platform.