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AI·Insurance

Insurance Claims Processor

Manual claims processing took 15+ days with 23% error rate in data extraction.

Overview

We built a document processing pipeline that automatically classifies, extracts, and validates data from insurance claims forms and supporting medical records — replacing hours of manual data entry with a human-in-the-loop review system.

Client

A regional insurance carrier...

Timeline

14 weeks

Team

2 engineers

Industry

Insurance

The Challenge

A regional insurance carrier processed hundreds of claims monthly using manual data entry. Adjusters spent the majority of their time extracting information from forms, medical records, and supporting documents rather than evaluating claims. Error rates were high, turnaround was slow, and the team was burning out on repetitive work.

Our Approach

1

Trained custom document classification models to identify different document types in a claims package

2

Built an OCR pipeline with post-processing rules for handling both printed and handwritten forms

3

Implemented entity extraction for medical codes, dates, amounts, and provider information using Python-based ML models

4

Created a human-in-the-loop review interface where low-confidence extractions get flagged for manual verification

Key Results

91%

Extraction Accuracy

5 days

Avg Processing Time

3x

Faster Than Manual

77→91%

Accuracy Improvement

Average claims processing time reduced from 15 days to 5 days

Extraction accuracy reached 91%, up from 77% manual baseline

Adjusters freed up to focus on actual claims evaluation instead of data entry

ROI achieved within 8 months of deployment

Our adjusters were spending more time on data entry than actual claims work. The extraction pipeline changed that completely. They actually evaluate claims now instead of copy-pasting from PDFs all day.

Operations Director, Insurance Carrier

Tech Stack

PythonGoogle Cloud Document AINode.jsPostgreSQLReactDocker

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