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Shift Technology
AI for Insurance Decisions

What is Shift Technology?

Shift Technology delivers advanced, AI-powered decision-making solutions specifically designed for the insurance sector. The platform focuses on enhancing crucial areas such as fraud and risk assessment, underwriting processes, and claims management, achieving exceptional accuracy and providing comprehensive explanations for every decision. It integrates into existing workflows, enhancing efficiency and supporting compliance across various insurance functions.

Shift's solutions analyze policies, claims, and documents using AI to provide insurers with actionable insights. The technology helps in detecting potential fraud, optimizing claims processes, and maintaining compliance, designed for easy integration and backed by a strong focus on security and data privacy.

Features

  • Claims Fraud Detection: Identify potential claims fraud with extreme accuracy and detailed contextual guidance.
  • Underwriting Risk Detection: Detect potentially fraudulent entities and applications prior to account opening.
  • Improper Payment Detection: Identify issues at the patient, provider, and network levels, beyond just fraud and waste.
  • Claims Document Decisions: Extract, analyze, and verify structured and unstructured claims data.
  • Claims Intake Decisions: Deliver a seamlessly integrated claims experience across multiple channels with AI decision support.
  • Subrogation Detection: Analyze claims data in real time to efficiently identify and investigate subrogation opportunities.
  • Financial Crime Detection: Examine entities and transactions to inform AML/KYC efforts and ensure compliance.

Use Cases

  • Detecting fraudulent claims in P&C insurance
  • Identifying high-risk applications in underwriting
  • Streamlining claims processing and document verification
  • Improving subrogation identification and recovery
  • Ensuring compliance with AML/KYC regulations in financial crime detection
  • Detect improper payments in healthcare insurance

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