AI Chatbot for Customer Representatives for a Medical Insurance Provider

THE BACKGROUND

Soothsayer’s client, a medical insurance provider, is digitally transforming its customer support and has determined key inefficiencies to address in business process such as longer training time for new customer representatives, high attrition rates among representatives, high dependencies on experienced representatives, longer call duration with end customer etc. One of the underlying root causes is that the representative must interact with the swamp of legacy applications and systems, modern solutions and third-party software that proliferated over time and store information in silos. A representative need to pull up at least three systems just to verify end customer and validate the policy before addressing the actual query. While client was evaluating multiple approaches and solutions to address above problem, they collaborated with Soothsayer to build an internal A.I. chatbot for its customer representatives that act as wrapper over existing systems for faster information retrieval.

The client was seeking an in-house Artificial Intelligence (A.I.) chatbot for service representatives which not only reduce the training time for service reps, but also reduce the call time due to faster information retrieval. Using this A.I. based chatbot, they also wanted to reduce the adverse impact of high turnover among service reps as well as enhance customer / provider needs and their experiences. In this engagement, the client wanted to assess their existing service representation interaction systems and develop an A.I. Chatbot which can replace these intermediate systems.