AI for PI (Christopher Draven, Crystal Son)
AI for Governance (Crystal Son, Simi Binning)
Revolutionizing Claims Processing: Responsible AI Strategies for Efficiency and Compliance (Fireside chat moderate by Dutch Noss)
Explore how responsible AI can revolutionize healthcare claims processing, payment integrity, and coordination of benefits. Learn actionable strategies for automating data workflows, improving claims adjudication, detecting fraud, enhancing compliance, and reducing member abrasion. This Fireside Chat will demonstrate how AI-driven insights streamline operations, reduce errors, and ensure financial and regulatory excellence.
Learning Objectives:
- Streamline Claims Processing: Leverage AI to automate workflows, improve accuracy, and reduce errors.
- Enhance Payment Integrity: Detect fraud, manage denials, and resolve overpayments efficiently.
- Optimize COB Management: Utilize AI for real-time eligibility checks, dynamic rule updates, and accurate payer sequencing.”
Christopher Draven
Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.
Crystal Son
Crystal Son is an Executive Director of Enterprise Data Analytics Solutions at Healthcare Service Corporation (HCSC). She has 19 years of experience in deriving intelligence from data.
At HCSC, she leads the Strategic Initiatives & Partnerships team, a department that focuses on cross-functional, collaborative analytics delivery on key programs such as Payment Integrity and Stakeholder Engagement, enterprise data and analytics strategy and planning, as well as design and execution of HCSC’s Responsible AI program. She is passionate about real-world applications of data-driven insights, storytelling through data, and building high-performance teams.
Simi Binning
Simi Binning is an accomplished healthcare professional with over a decade of experience in developing and executing successful strategies that drive business growth. Currently serving as a Responsible AI lead at HCSC, her focus is on AI governance and innovative problem solving.
Dutch Noss
Dutch Noss, COO of PrecisionGx is a highly versed Operations leader with 20+ years in Payment Integrity, Revenue Cycle Management, and Product Development. Dutch is an expert in the operational use of Artificial Intelligence, Machine Learning, Predictive Analysis, and Gaming Theory. Dutch’s specialties span both clinical and non-clinical audits including Contract Compliance, Duplicate Payments, IBill & DRG Review, COB, TPL, Retro-term, FWA and RAC audits in pre and post pay settings for Commercial, Medicare, and Medicaid payers.”