Work Board

This feature may need to be enabled for your account. The Work Board is turned on per practice. If you don't see Work Board in your left-hand navigation menu, or you see it but rejected, denied, and no-response claims never appear on it automatically, your account may not be set up for it yet. Contact ClaimRev support to request access (see the bottom of this page).

The Work Board is your single place to see and work every claim that needs a human, plus any follow-up tasks you create. Instead of hunting through claim search for problems, the Work Board brings them to you: payer rejections, clearinghouse (front-end) rejections, denials, claims that have gone quiet with no response, and your own to-dos, all in one prioritized, assignable list.

It's built to be a daily worklist: assign items to your team, set priorities and due dates, leave notes, and move work across columns as it progresses.

Items arrive two ways.

Automatically (when enabled for your account):

• Payer rejections: a payer rejected the claim (from a 277 response)
• Front-end rejections: the clearinghouse rejected the claim before it reached the payer (from a 999 response)
• Denials: the payer denied the claim on the remittance (from an 835 / ERA)
• Validation errors: ClaimRev's own validation stopped the claim before it was ever sent
• No response: the claim was sent but nothing has come back within the expected window, so it's flagged for follow-up. The board checks for these each morning, and again when you open it (at most once an hour)

Manually (any time):

• Add a claim: from a claim in Claim Search, use the Work Item button to add it to the board
• Create a task: use + New Task on the board to add a free-standing to-do that isn't tied to a single claim (for example, “Call BCBS about the prior auth on the Smith account”)

The Work Board has two views you can switch between:

• Board view (Kanban): cards arranged in columns by status; drag a card to a new column to update it
• Table view: the same items as a list, one row per item, handy for scanning a lot at once. Click a row to open it

Every item moves left to right as you work it:

• New: just arrived, not started
• In Progress: someone is actively working it
• Waiting: you're waiting on something (a payer, a provider, more information)
• Resolved: done

To change an item's status, drag its card to another column, use the Move to status button on the card (the two-arrow icon, which also works from the keyboard), or change it from the item's detail panel.

Swimlanes split the board into horizontal rows, each with its own set of status columns. Use the Swimlanes dropdown in the filter bar to choose how cards are grouped:

• By reason (the default): all denials together, all no-response claims together, and so on
• By assignee: one row per teammate, plus an Unassigned row, so you can see each person's workload at a glance
• By payer: one row per payer, useful when you're working one payer's problems in a batch
• No swimlanes: one plain board with every card in it

A row only appears when it has at least one item in it.

Dragging a card moves it between columns within its own row. You can't drag a card into a different row. To move an item to another row, change the thing the rows are grouped by: open the item and reassign it (to move it between assignee rows) or reclassify its reason (to move it between reason rows).

The filter bar narrows the board by reason, assignee, or payer.

If you are one of your practice's Work Board team members, the board opens filtered to your own items. To see everyone's work, clear the assignee filter.

• The reason (a colored badge, see below)
• Where the item came from: a Claim, an ERA, or a Task
• The claim's filing order (PRIMARY, SECONDARY, or TERTIARY), so you know which payer in the coordination-of-benefits order this claim was billed to. Hover over it for an explanation
• Priority, when one is set
• The patient and claim number (or the task title)
• Payer and claim dollar amount
• Assignee (who owns it)
• Due date and days aging (how long it's been on the board)

Each item is tagged with a reason so you know why it needs attention:

• Payer Rejection: the payer rejected the claim
• Front-End Rejection: the clearinghouse rejected it before the payer saw it
• Validation Error: ClaimRev's own validation stopped the claim before it went out. These are yours to fix and resend, and the item closes itself once the claim stops failing validation
• No Response: sent, but no acknowledgment or payment within the expected window
• Denial: denied on the remittance
• Manual Review: flagged by a person for a closer look
• Task: a free-standing to-do you created

If an item came in with the wrong reason, you can reclassify it (see below).

Click any card (or table row) to open its detail panel on the right-hand side of the screen, where you can:

• Assign it: pick a teammate from the assignee list so it's clear who owns it
• Set priority: flag the urgent ones
• Set or change the due date: this drives reminders (see Notifications below)
• Add notes: every note is timestamped and kept on the item's timeline, so anyone who picks it up can see the history
• Reclassify the reason: change the reason if it was categorized incorrectly
• Send to Workbench: for a denial you intend to appeal, send it to the Denial Workbench, where the appeal tools live (see the Denial Workbench guide). You can also do this from the arrow button on the card. Either way, you'll be asked to confirm, because the item leaves the Work Board
• Close the work item: when it's fully handled

For items tied to a claim, the detail panel carries two tabs so you can work the item without opening another screen:

• Claim Detail: patient, payer, provider, service and received dates, billed amount, status, the claim/patient control number, payer control number and trace number, plus the service lines. A More detail area underneath holds the full claim tabs, including any errors on the claim
• ERA Detail: for items that came from a remittance, the claim-level and per-line CARC codes and RARC remarks that explain the denial

The ERA Detail tab only appears on items that have a remittance attached.

Practice administrators only. Go to Practice Admin → Work Board → Work Board Configuration. Everything here applies to your own account.

• Team & Notifications: choose your team members (these are the people who can be picked as an assignee), then choose your triage owners from that list. Triage owners are the people notified about items that nobody has been assigned yet. Set at least one, so unassigned work always reaches someone (see below)
• No-response floors: how many days after a claim is sent before it counts as “gone quiet”. Set an account-wide default, and override it per payer for the payers that are reliably slower or faster
• Reason SLAs: how many days after an item is detected before it's due. Leave a row blank to use the built-in default: front-end rejection 5 days, payer rejection 7, no response 14, denial 30, validation error 3. Manual Review and Task have no automatic SLA, since you set those due dates yourself
• Classification rules: how denials from the remittance are categorized. Most accounts should leave Use default classification rules checked

If you don't see this screen, your sign-in doesn't include work board configuration yet. Contact ClaimRev support.

Two things watch your board for you.

• Due date reminders: when an item reaches its due date, the person it's assigned to is notified. If nobody is assigned, the reminder goes to your triage owners. If you have no triage owners set, reminders for unassigned items go to no one
• A daily digest: a once-a-day summary of everything still open. Each person gets a digest of their own items. One digest covering the unassigned items goes to your triage owners, or, if you haven't set any, to your practice's primary contact on file with ClaimRev

Auto-detected items get a due date automatically from your Reason SLAs, so rejections and denials start aging against a deadline without anyone having to set one. For anything you add by hand, set a due date so it doesn't slip.

Reminders and digests appear in the portal on the notification bell, and are also sent by email. Email is delivered in batches rather than the instant an item comes due, so allow up to an hour for it to arrive. The bell updates straight away, so it is always the faster of the two.

If unassigned items are going unnoticed, check Team & Notifications first and make sure at least one triage owner is set.

Move an item to Resolved (or use Close work item from the detail panel) when it's handled.

• Resolved items stay visible on the board for about 30 days so you can confirm the outcome, then they drop off the active board automatically.
• Closing an item removes it from both the board and the workbench but keeps its full history.

Think of the Work Board as the front door for everything that needs attention, and the Denial Workbench as where you do the appeal work.

• New rejections, denials, no-response claims, and tasks land on the Work Board first.
• When a denial needs a formal appeal, Send to Workbench moves it into the Denial Workbench, where you get appeal letters, timely-filing tracking, and the rest of the appeal tools.
• An item you send to the workbench keeps all of its notes and history.

If you only need to manage denials and appeals, the Denial Workbench guide covers that surface in depth.

The Work Board is enabled per practice. Three things to check:

1. No “Work Board” in your menu? Your sign-in may not include access to it yet. Contact ClaimRev support to request it.
2. The board looks emptier than you expect? If you're a team member, the board opens showing only items assigned to you. Clear the assignee filter to see everything.
3. You see the board, but rejected, denied, and no-response claims never appear on their own? Automatic detection may not be turned on for your account yet. You can still add claims and create tasks manually, but to have problems surface automatically, contact ClaimRev to enable it.

See also: Denial Workbench · Claim Search

Need help? Contact ClaimRev support at help@claimrev.com or call 918-842-9564.