Benefits Carrier Invoice Reconciliation Agent

Each month, insurance carriers send invoices listing covered employees and premiums, and small errors add up over a year. This agent imports each invoice and the benefits system enrollments, and matches lines by employee ID, plan and tier. It also compares payroll deductions. It finds employees billed but not enrolled, enrolled but not billed, or billed at the wrong tier, calculates the difference and drafts a correction request. The administrator approves payment and the requests. When the next invoice arrives, the agent checks whether the corrections were made; if not, it follows up with the carrier. Retro limits are checked on every credit. Edge case: retroactive terminations older than the carrier's limit are flagged as possibly unrecoverable so nobody waits for a credit that will not come.