AI/ML-Powered Claim Validation & Invoice Verification System
AI Powered Claim Verification and Invoice Validation Tool
An intelligent automation platform that cross-validates insurance claims against invoices, flags anomalies, and accelerates clean-case approvals.
Overview
Built an AI-driven document processing platform to automate insurance claim reviews. The system extracts data from claim documents and invoices, validates against policy rules, detects anomalies, and routes exception cases to human reviewers.
Problem Statement
The claims team processed 500+ claims per week manually by checking invoices, policy docs, and supporting records line by line. Each claim took 5-7 days, error rates were high, and fraud detection had no automated support.
Solution
Designed a multi-stage AI pipeline with OCR ingestion, rules-based cross-validation, and anomaly detection. Clean cases are auto-approved while flagged cases go to reviewer dashboards with discrepancy highlights and confidence scoring.