The brief
Shrayan Health TPA (fictional) is a third-party administrator in Pune that processes reimbursement health claims for four insurers. You have been introduced to the CEO by your account manager.
Facts shared so far:
- 41,000 reimbursement claims are pending. Average turnaround is 19 days; the contractual SLA with insurers is 15 days, and two insurers have started applying penalties.
- Claims arrive as scanned PDFs and phone photos: claim form, discharge summary, hospital bills, pharmacy bills, prescriptions, KYC. Mix of English, Hindi and Marathi, some handwritten.
- 160 medical and claims officers review claims in a workflow tool built in-house in 2019.
- Around one in four claims is sent back for missing documents, which restarts the clock.
The CEO says: "Everyone is using GenAI now. I want you to use it to clear our backlog by March. What will you build?"
You have 20 minutes with her. Write how you would break the problem down. The interviewer wants to see what you ask and how you define success before any solution.
How it's graded
- Asks clarifying questions before proposing a solution3 pts
- Defines 'clear the backlog' as a measurable target with guardrails3 pts
- Proposes a first step matched to the bottleneck, not a big platform2 pts
- Covers risks: wrong payouts, health data, handwriting, adoption2 pts