ClaimsXM: A Modern Claims Platform Where Modernization Drives Transformational Change

Healthcare organizations today are under more pressure than ever to process claims faster, more accurately, and with greater compliance, all while reducing the administrative costs and burdens. With more than 20 years of experience in the federal healthcare space, Signature Performance understands the challenging reality that many legacy systems and manual workflows simply can’t keep up with the complexity and speed healthcare organizations now require.

That challenge is exactly what led to the development of Signature's ClaimsXM platform, a healthcare claims processing solution designed to deliver accuracy, automation, and security at scale. What we find most compelling about our platform is that it doesn’t just focus on technology, but it combines a modern, configurable system with the deep operational expertise needed to make claims administration work in real-world federal healthcare environments.

Secure and Compliant by Design

One of the first things health systems look at when evaluating a claims platform is how seriously it manages security and compliance. With Signature’s ClaimsXM platform, those elements aren’t afterthoughts, they’re deeply woven into the foundation of the platform.

ClaimsXM holds FedRAMP® authorization and maintains compliance with HIPAA, NIST, and FISMA, while operating within the secure Microsoft Azure Government Cloud. For organizations navigating increasingly complex regulatory requirements, that level of built-in security provides reassurance that sensitive patient and payment data is protected throughout the entire claims lifecycle, without creating additional compliance burden for health systems and providers.

Expertise That Shapes the Platform

What stands out most about Signature’s ClaimsXM platform is the level of federal healthcare expertise that went into the design and configuration. Many platforms provide a standard set of tools and leave organizations to figure out the rest. ClaimsXM takes a different approach, incorporating decades of industry expertise into the development, configuration, implementation, and execution phases of the platform.

Our in-house subject matter experts bring deep knowledge of healthcare policy, billing standards, and complex program requirements and take a hands-on approach to shape how the platform is configured and deployed. That means the system isn’t relying on generic processing logic. Instead, it incorporates program-specific business rules, intelligent claims edits, and configurable decision frameworks that reflect how real claims operations function. In practice, that translates into a platform that processes claims the way an experienced operations teams would, but at a speed and scale that manual processes simply can’t achieve.

Built to Scale to Complex Healthcare Environments

Two stand-out strengths of ClaimsXM are its scalability and configurability. No two healthcare organizations operate in the same way, and claims platforms need to reflect that reality. ClaimsXM is designed to scale seamlessly to meet the needs of healthcare organizations of any size, from small clinics to large health systems, while consistently maintaining high standards of quality and accuracy. Its flexible architecture ensures that as volumes increase or requirements become more complex, the platform delivers reliable, precise claims processing without compromising operational performance or compliance.

Signature’s ClaimsXM platform supports complex eligibility structures, customizable claims edits, and dynamic rule sets, making it adaptable to a wide range of healthcare programs and operational models. The platform also offers configurable dashboards, role-based analytics, and a self-service reporting portal that allows organizations to monitor performance, identify trends, and make informed operational decisions. With low-code and no-code configuration capabilities, organizations can continuously refine their workflows without requiring extensive IT resources or long development timelines.

Automation That Delivers Operational Impact

ClaimsXM embeds advanced automation and configurable business rules directly into the claims processing and adjudication lifecycle, reducing the number of manual touchpoints required to move claims through the system. In large-scale claims environments, ClaimsXM has achieved auto-adjudication rates exceeding 94%, along with a consistent two-day clean claim rate.

The impact of that level of automation is significant. Fewer manual interventions translates into lower administrative costs, faster provider payments, and more time for teams to focus on higher-value activities. At the same time, the platform can respond quickly to regulatory and pricing changes, keeping reimbursement logic current without lengthy development cycles.

Looking Ahead

Modernizing claims operations isn’t just about adopting new technology. In our experience, it’s about finding solutions that combine strong technology capabilities with the expertise required to configure and operate them effectively. Signature’s ClaimsXM platform reflects how technology, automation, and deep healthcare knowledge can come together to help organizations process claims more efficiently, maintain compliance, and scale their operations as the healthcare landscape continues to evolve.

Discover What ClaimsXM Can Achieve for Your Organization: www.signatureperformance.com/claimsxm.