A Leading U.S. Health Insurer Automates Benefit Booklet Creation Leveraging Coforge’s GenAI-Powered Quasar Engine
Overview
A leading U.S. health insurer initiated a strategic effort to modernize its benefit booklet creation process and improve operational efficiency.
To reduce manual efforts, improve accuracy, and accelerate turnaround times across lines of business, the organization needed a strategic partner to automate and streamline benefit booklet operations using AI-driven capabilities.
Non-standard IT systems and manual processes slowed operations
Poor integration across applications created workflow inefficiencies
High Error Rates & Rework
Lack of advanced matching rules led to manual benefit booklet creation
Quality defects and inconsistent process manuals across lines of business resulted in rework
Operational Bottlenecks
High turnaround times due to staffing constraints and inefficient processes
Heavy reliance on experienced personnel with long training cycles
Limited Process Governance
Inconsistent workflows and lack of structured prioritization impacted operational visibility and accountability
Solution
Coforge implemented an AI-driven automation framework powered by Quasar GenAI, transforming the creation of benefit booklets into an intelligent, streamlined process.
AI-Powered Data Processing
Deployed GenAI models using the Quasar engine with trained LLMs
Automated ingestion, interpretation, and extraction of benefit data from complex documents
Intelligent Workflow & Validation
Implemented a flexible workflow platform for validating and processing outputs
Enabled end-to-end inventory visibility and process transparency
Operational Governance Framework
Introduced transaction monitoring, weekly governance reviews, and monthly performance reviews
Implemented FIFO workflow management aligned with business priorities
Reporting & Priority Management
Enabled structured reporting and prioritization mechanisms
Improved operational tracking and business alignment
Workforce Optimization
Refined job descriptions to recruit experienced talent
Established a Knowledge Bank, process maps, and checklists to standardize execution
The Impact
75% Reduction in Processing Time Automation significantly accelerated the creation of benefit booklets and reduced operational cycle times.
100% Accuracy AI-enabled validation eliminated errors and minimized rework.
End-to-End Work Queue Ownership Coforge assumed full accountability for assigned work queues, enabling streamlined operations.
Flexible Operating Model A dynamic staffing model enabled rapid scaling during peak workloads while maintaining consistent output quality.
