Claims adjudication, onboarding, and other high-friction workflows reveal where AI can create measurable impact and lasting competitive advantage
Every organization exploring AI faces the same question: Where should we start?
The temptation is to begin with simple tasks because they’re easier to automate. But in my experience, the biggest opportunities are rarely found in low-friction processes. They’re found in the workflows that create the most frustration for customers, employees, and administrators.
Consider healthcare claims. Manual claims adjudication is often slow, expensive, and prone to human error. As claim volumes increase and plan designs become more sophisticated, administrators are forced to dedicate more resources simply to keep up. Participants wait longer for reimbursements, administrators face growing operational burdens, and organizations struggle to scale efficiently. Which is exactly the kind of friction AI should address.
The goal isn’t to automate decisions blindly. It’s to remove unnecessary complexity while preserving control. That’s why we’re building AI-powered claims capabilities that allow administrators to define eligibility rules, configure review thresholds, and determine exactly where human oversight should remain in the process.
The same principle applies beyond claims. During HSA onboarding, even a relatively small failure point can create outsized consequences. Even if only 5-10% of new HSA applicants fail their initial Customer Identification Program (CIP) verification due to data entry errors or other issues, the resulting document review process can create confusion for participants, increase manual work for operations teams, and ultimately lead to abandoned account applications when applicants choose not to complete the verification process.
Historically, the challenge wasn’t a lack of effort from participants or administrators. It was friction. Participants often didn’t know exactly what document to provide. Operations teams were forced into repetitive review cycles. Support organizations handled thousands of related inquiries. Alegeus’ AI-powered CIP solution is already having an impact in this area.
Organizations sometimes ask where AI will create the most value. I believe the answer is straightforward: start where complexity is highest, where manual effort is greatest, and where the customer experience suffers the most. If a workflow creates frustration today, it’s probably one of the best places to explore AI tomorrow.
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Arjun Srinivasan is the Chief Product Officer at Alegeus, leading the company’s Product Management organization to deliver product solutions that create compelling outcomes for Alegeus partners, their customers, and healthcare consumers. With more than 25 years of experience, Arjun brings a proven track record of building and scaling market-leading digital products.