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ClaimJumper is an AI-assisted denial triage tool for medical billing teams. Upload a PNG EOB or remittance screenshot and ClaimJumper uses GPT-5.6 to extract every claim and service line, route each denial to the right resolution path — appeal, corrected claim, patient bill, write-off, or human review — and draft cited work packets ready for a reviewer to validate and act on.

Introduction

Understand what ClaimJumper does, how it fits into a billing workflow, and what it deliberately does not do.

Quickstart

Clone the repo, configure your OpenAI API key, and run your first triage in minutes.

Demo Walkthrough

Step through a full triage session using the included sample EOB to see every lane in action.

Pipeline Overview

Explore how ingest, triage, prioritization, and drafting connect end-to-end.

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How it works

1

Upload a PNG EOB screenshot

Drop or select a PNG remittance image in the browser. ClaimJumper accepts only PNG — no PDF, no CSV, no HL7.
2

Structured ingest

GPT-5.6 Sol extracts every claim, service line, adjustment code, and code-legend definition into a Zod-validated schema. Results are cached by image hash so repeated uploads are instant.
3

Denial triage and prioritization

Each denied service line is routed to one of five lanes by GPT-5.6 Sol, then code-enforced safety invariants run. Lines are ranked deterministically by appeal deadline, billed amount, and recovery probability.
4

Draft and review

Appeal and corrected-claim lines get cited drafts from GPT-5.6 Terra. Human-review lines get a deterministic safety brief. A reviewer approves eligible drafts, then downloads a citation-preserving text bundle.

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Explore the docs

Denial Lanes

Learn the five routing lanes and what ClaimJumper provides for each.

Safety Invariants

Understand the non-negotiable code-enforced rules that protect billing teams.

Draft Artifacts

See how cited appeal drafts and corrected-claim worklists are generated and validated.

Triage API Route

Full reference for the POST /api/triage endpoint including request shape and response schema.

Schemas

Every Zod schema and TypeScript type exported from the pipeline.

Limitations

Scope boundaries, known constraints, and what ClaimJumper is not designed to replace.
ClaimJumper is AI-assisted, not autonomous. Every downstream action — submitting an appeal, filing a corrected claim, billing a patient, writing off a balance — requires a human to validate requirements and carry the work into the organization’s approved billing workflow.