Claims & operational improvement
Assess workflows, identify gaps, and define more effective ways of working across claims and related business functions.
Process assessment · Workflow design · Business controls
Claims. Operations. Technology.
Practical consulting at the intersection of healthcare, insurance, and technology.
We help organizations translate business challenges into clear requirements, stronger processes, and solutions that work in the real world.
Let’s talk about your prioritiesOur expertise
From the details of a claim to the design of a platform, we connect operational needs with a clear path to delivery.
Assess workflows, identify gaps, and define more effective ways of working across claims and related business functions.
Process assessment · Workflow design · Business controls
Turn operational needs into actionable requirements, helping business and technical teams build a shared understanding of what a solution must do.
Discovery · Requirements · Platform planning
Support claims data review, overpayment identification, and recovery processes with attention to documentation and operational follow-through.
Data review · Recovery workflows · Issue resolution
Help teams move from planning to execution through coordination, business validation, and practical implementation support.
Delivery coordination · Testing support · Transition planning
Our approach
Technology works best when it reflects how the business needs to operate. We bring structure to the problem, align the people involved, and keep the work focused on practical outcomes.
Clarify the current state, priorities, constraints, and people affected.
Translate those needs into a focused scope, clear requirements, and an achievable plan.
Work alongside business teams and technology partners to support execution and validate results.
About PJX
Founded in 2012, PJX Consulting, Inc. brings claims, operational, and systems expertise to healthcare and insurance organizations.
We work with business leaders, operational teams, and technology partners to make complex initiatives easier to define and execute. Our role is to connect the business detail with the bigger picture—and help move both forward.
Connect with PJX
Tell us what you’re working on.
info@pjxconsulting.com571-252-5300