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Insurance·July 2024
Monitoring Solution for Claim Processing Failures
Real-time monitoring and exception routing for claim processing failures.
Real-time
Failure detection
Routed
To reviewers automatically
Challenge
The problem
Claim processing failures were being detected too late — driving downstream rework and member friction.
Approach
How we engineered it
- 1Built real-time monitoring across the claim adjudication pipeline
- 2Engineered exception routing with reviewer queues and SLA tracking
- 3Implemented anomaly detection for emerging failure patterns
- 4Closed the loop with write-back into the source claim system
Outcomes
What shipped
Measured outcomes from the program — not promises.
Real-time
Failure detection
Routed
To reviewers automatically
Technology
What we built it on
KafkaDatadogSalesforce Service Cloud
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