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Sagitec Blog

3 ways in Which Artificial Intelligence can help the Benefits Administration Industry

Automation with Artificial Intelligence (AI) is becoming common today. AI unlocks productivity gains and it makes process outcomes precise and accurate and is scalable technology. Intelligent machines are likely to open new avenues for us to explore, freeing us from mundane, routine tasks and giving us an opportunity to leverage our creativity and imagination.

Today, AI is no longer just associated with high-level computation, data-driven optimization or reducing manual labor – you have chatbots, home and office assistants, and advisors. These AI technologies are also making their foray into the benefits administration space of pension, unemployment insurance (UI) tax and benefits, and healthcare plans.

Artificial Intelligence, Fraud, Chatbots

Let’s take a look at 3 ways where AI can help in improving the benefits administration industry.

  1. Chatbots – Chatbots today have the capability to use natural language processing and understand questions members or employers have in the pension or UI space. They can apply for a refund, add a beneficiary to their pension application or check for steps on submitting wages and payments – just by asking the chatbot. Medicaid members can be engaged more effectively by administering surveys and reminders about their health and wellness. Chatbots understand context and intent and point to descriptive steps that members and employers can take for their questions.
  2. Preventing fraud – the UI program is not only one of the government's largest benefit programs but it also has one of the highest error rates among all government benefit programs. With advances in predictive analytics, machine learning, and data modeling, there are technology solutions that can sift through historical claim data on previous fraud cases. The result of this analysis is a trained fraud model that can accurately predict the likelihood that claimants will commit fraud. These models can be applied to UI claim data identifying fraud before it occurs or very early in the process so that follow up and investigations can occur to help reduce or eliminate the fraudulent claims.
  3. Financial advisory – Though baby boomers use computers and smart-phones, they are behind the curve when it comes to taking complex retirement decisions like how much to invest or withdraw, or whether they have enough for their retirement. And millennials are rarely thinking about retirement. A recent study by the ILC-UK on the value of financial advice found that those receiving financial advice could increase liquid assets over the course of their life by as much as 32%. AI is increasingly being used as an advisory. Based on minimal client data, the first generation of these intelligent advisors provided steps to allocate assets. The next generation is focusing on providing fully regulated, online advice in the complex pensions sector, for example. AI can be used to understand risk appetite, retirement goals, and then provide recommendations based on the data it has gathered.

There are many benefits of using these advanced technologies. They increase efficiencies; automation with AI reduces workloads of agents in the benefits administration space who can then focus on other value-added tasks. They empower members and employers to answer their own questions, process their own requests, and enter data and resolve business validations and edit checks without involving your staff. They help in reducing much of the manual work and ensuring cases meet timeliness and quality standards.

AI is already making waves in many industries like retail and finance – will the benefits administration follow suit and be one of the early adopters of these technologies?

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Topics: chatbots, fraud