Harnessing AI
with Data Science
The
Assignment
A leading health insurance provider wanted to improve the quality and efficiency of their business operations. So we provided expert Data Science services, leveraging our AI/Machine Learning capabilities to streamline their operations. Our responsibilities included:
- Implementing and configuring Artificial Intelligence and Machine Learning technologies into a legacy environment
- Replacing the manual process of extracting and entering insurance policy data via Natural Language Processing (NLP)
- Establishing a persona classification system for Medicare Advantage policy members
- Streamlining the review and analysis process for medical record procedure identification via NLP
- Dramatically improving the verification of medical records indicating chronic conditions
What We Delivered
By leveraging and implementing AI/ML technologies, we were able to improve the efficiency and accuracy of multiple documentation review processes, saving our client both time and money. Our contribution included:
- Architected and configured the client’s Machine Learning and Data Science environment via technologies such as Docker, Kubernetes and Snowflake
- Designed the client’s AI/ML development process and related standards
- Built a Natural Language Processing (NLP) model to identify and extract policy data without human interaction at an 96% rate of accuracy
- Enhanced speed and efficiency of the review process for medical procedure documentation
- Reduced the number of false positive findings for medical record re-certifications
- Classified members into various personas aimed at targeted communications and staffing/training alignment