Back to Work
HealthTech / Insurance · Infosys (Healthcare Insurance Client)
The 72-Hour Claim
Cutting insurance claim processing from 3 days to 24 hours.
Jun 2016 – Jun 2020
60K+
Monthly Claims
72 → 24hr
Processing Time
10M+
Records Governed
35%
Data Errors Reduced
45%
Exposure Vectors Reduced
The Problem
A large US healthcare insurance client was processing 60K+ claims per month with a 72-hour SLA — routinely breached. Provider data errors were high, onboarding was slow, and PII/PHI exposure across 15+ sensitive fields was a compliance risk.
The Approach
- 01Redesigned the end-to-end claims process workflow with an agile team of 20+ engineers
- 02Implemented HIPAA-grade governance controls — RBAC policies, step-up approvals for sensitive edits
- 03Built PII/PHI masking across all 15+ sensitive fields
- 04Developed an end-to-end provider management platform for 5,000+ users
- 05Built messaging triggers for policyholders, claims updates, and provider actions
Impact
- ✓Claim processing time cut from 72 to 24 hours for 60K+ monthly claims
- ✓Provider data errors reduced by 35%, onboarding time by 15%
- ✓Exposure vectors reduced by 45% across 10M+ records
- ✓Messaging trigger system improved outreach efficiency by 35%
- ✓Support queries related to status uncertainty reduced by 25%