Claims management system

The project was developed in collaboration with Foundevs technology partner from Lithuania.

The system enables efficient handling of medical claims and invoices for insurance companies. Medical providers send their bills to the system, which then calculates the payments and offers payment recommendations to the insurance companies. This platform is constructed using state-of-the-art technologies, providing unparalleled flexibility, scalability, and reliability. Its cloud-based, containerized design, along with optimal orchestration and monitoring, ensures a seamless user experience.

The main modules of this project are:

1. KSD Finance The part of the system that deals with invoicing and payments;

2. KSD Accounting The part of KSD Finance that handles reconciliation and accounting;

3. KSD Review The part of the system that handles the medical claims and bill review process;

Foundevs developers have been involved in the backed development of all parts of the platform (KSD Finance, KSD Accounting, KSD Review).

Java-backed application offers a REST API with numerous endpoints that are safeguarded by filters to manage access. Not only is access granted through JWT authentication token, but user roles are also taken into consideration when accessing specific API endpoints. These endpoints can be used to perform small and large calculations, create, retrieve, and update values in the database, as well as complex searches with pagination and filtering by an array of properties.

The backend is divided into 3 primary standalone applications and 3 additional microservices for added functionality. Communication between them is facilitated through HTTPS requests and RabbitMQ message broker. Additionally, the application has scheduled cron jobs that are managed and executed using Apache Camel routes. These jobs are used for various purposes, the most popular being the generation of daily reports that are stored in AWS S3 and SFTP server. The backend also provides a feature for sending emails.