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Top 18 Core Administrative Processing Systems Software SaaS Companies in May 2026

As of May 2026, there are 18 SaaS companies in Core Administrative Processing Systems Software. They have combined revenues of $1.1B and employ 9.7K people. They have raised $13.2M and serve - customers combined.

Core Administrative Processing Systems Software (CAPS) encompasses a set of solutions that support the administrative functions of organizations, particularly within the healthcare sector. These systems manage critical processes such as claims processing, member enrollment, benefit configuration, and billing, enhancing operational efficiency and accuracy. By automating various administrative tasks, CAPS enable organizations to streamline workflows, reduce operational costs, and improve customer service. Typical users of Core Administrative Processing Systems include healthcare payers, insurance companies, and healthcare providers, who rely on these solutions to ensure smooth claims management and regulatory compliance. Key features of CAPS often encompass data integration, analytics, and reporting capabilities, allowing for better decision-making and performance tracking. As the healthcare landscape continues to evolve, the demand for effective administrative processing software remains crucial to the success of health plans and related organizations.

Companies
18
Revenue
$1.1B
Funding
$13.2M
Employees
9.7K

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Top Core Administrative Processing Systems Software Companies

Showing 10 of 3 companies ranked by annual revenue.

1
Zelis

Boston, Massachusetts, United States

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. Zelis maintains a transparent, fee-free recruitment process. All genuine offers originate from our Talent Acquisition team using the “@ zelis.com” domain. We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to verify-offers[@]zelis.com for prompt investigation. Thank you for staying vigilant.

Revenue
$306.8M
Customers
-
Year founded
2016
Funding
-
Team size
2.8K
Growth
-
2
HealthEdge

Boston, Massachusetts, United States

HealthEdge is on a mission to drive a digital transformation in healthcare. We’re connecting health plans, providers, and patients with end-to-end digital technology solutions to support new business models, reduce administrative costs and improve health outcomes. Our growing portfolio of products (HealthRules® Payer, HealthEdge Source™, HealthEdge® Provider Data Management, GuidingCare®, and Wellframe™) provides talented and passionate professionals with opportunities to lead change and make a lasting, global impact in healthcare. Driving our mission are 2,000+ professionals worldwide. Together, we are committed to innovating a world where healthcare can focus on people.

Revenue
$217.7M
Customers
-
Year founded
2005
Funding
-
Team size
2K
Growth
-
3
Veradigm®

Chicago, Illinois, United States

Veradigm is an integrated data systems and services company that combines data-driven clinical insights with actionable tools to help healthcare stakeholders improve the quality, efficiency, and value of healthcare delivery—these stakeholders include biopharma, health plans, healthcare providers, network partners, and most importantly, the patients they serve. We build solutions that are designed to help healthcare stakeholders to improve patient lives through data driven insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life. As a result, Veradigm attracts leaders in healthcare, technology, and innovation, seeking to work with us to deliver insights and solutions to the benefit the healthcare ecosystem with the objective being to improve healthcare quality while lowering the cost of healthcare. Veradigm is an organization comprised of passionate and energetic people whose everyday focus is on helping all healthcare stakeholders drive the best care possible for healthier communities. We believe diversity is the foundation of innovation, and we are dedicated to fostering an inclusive environment that supports the talents of all people.

Revenue
$191.5M
Customers
-
Year founded
1986
Funding
-
Team size
1.7K
Growth
-

Inclusion Criteria

- Must automate core administrative tasks such as claims processing and billing - Should facilitate member enrollment and benefit configuration - Needs to support regulatory compliance and reporting requirements - Must integrate with existing IT systems and databases - Designed for use by healthcare payers and providers - Not just focused on claims management; must also provide analytics and operational insights