Trusted by operators managing 40+ insurers worldwide

The AI Agent Platform
for Payer Operations

Deploy purpose-built agents that handle member support, claims processing, enrollment, renewals, and more. One platform. Every payer workflow. 55% automation rates in production today.

Explore a Pilot (4 Weeks)

No long-term contracts. Prove value before you scale.

Trusted by TPAs, health plans, and insurtechs

AXA
Liberty
Jubilee
Old Mutual
Sanlam
Bupa Arabia
Y Combinator

One platform. Every agent your operations need.

Whether you're a 50-person TPA or a 500-person health plan, Soteria deploys agents tailored to your workflows. Start with one agent and a clear success metric. Add more as you prove value.

Support Agent

Member/provider queries, eligibility, benefits

For: TPAs, Health Plans

Claims Agent

Intake, routing, adjudication, fraud flags

For: TPAs, Insurtechs

Plan Agent

Enrollment, eligibility verification, document processing

For: Benefits Admins, TPAs

Renewal Ops Agent

Stop-loss renewal packets, PDF extraction, audit prep

For: MGUs, Stop-Loss Carriers, Brokers

Fraud Agent

Pattern detection, suspicious claims flagging

For: TPAs, Health Plans, Carriers

Custom Workflows

Any repetitive payer process you want automated

For: Everyone

Stop running 2026 operations
on 1995 processes

Manual Operations

  • ✕
    Member Support: 15-minute hold times, offshore call centers with 30% error rates
  • ✕
    Claims Processing: Manual intake, paper routing, weeks of turnaround
  • ✕
    Enrollment: Document piles, eligibility backlogs, compliance anxiety
  • ✕
    Renewals: Weeks of PDF wrestling, data entry, audit prep by hand
  • ✕
    Fraud Detection: Catch it after you've paid. Maybe.
  • ✕
    Reporting: Spreadsheets cobbled together every quarter

Soteria AI Agents

  • ✓
    Support Agent: Instant answers, 24/7, 95%+ accuracy, zero hold time
  • ✓
    Claims Agent: Automated intake, intelligent routing, same-day processing
  • ✓
    Plan Agent: Documents extracted, verified, and routed in minutes
  • ✓
    Renewal Ops Agent: Hundreds of PDFs turned into audit-ready packets automatically
  • ✓
    Fraud Agent: Real-time pattern detection before claims get paid
  • ✓
    Dashboards: Live visibility into what's automated and what's not
Explore a Pilot (4 Weeks)

Your best support rep works 24/7
and never puts anyone on hold

Handle 70% of member and provider queries automatically. Eligibility checks, claims status, benefits questions. Connected to your payer systems (EDI 270/271, FHIR). Complex cases get escalated to your team with full context.

70%
of support volume automated
0 min
hold time
95%+
accuracy
50%
reduction in support costs

Built for: TPAs, Regional Health Plans, Provider Groups

Explore a Pilot

Claims intake that routes itself

Ingest claims from any channel (fax, email, portal, EDI). AI extracts data, classifies the claim, checks for errors, flags fraud indicators, and routes to the right queue. Your adjusters focus on complex cases, not data entry.

Same-day
processing for routine claims
80%+
auto-routing accuracy
Real-time
fraud pattern detection
Full
audit trail on every decision

Built for: TPAs, Insurtechs, Health Plans

Explore a Pilot

Enrollment that doesn't create a backlog

Documents come in. Agents extract the data, verify eligibility against plan rules, flag exceptions, and route for approval. No more document piles. No more eligibility gaps. No more compliance headaches.

80%
of enrollment handled automatically
Days → Hours
processing time reduced
100%
compliance-ready documentation
$150K+
annual savings in processing costs

Built for: TPAs, Benefits Administrators, Small Health Plans

Explore a Pilot

Renewal season without the chaos

Hundreds of pages of PDFs, broker submissions, and spreadsheets turned into audit-ready renewal packets. Agents extract claims data, member demographics, and underwriting details. Your underwriters analyze risk instead of formatting documents.

Weeks → Hours
renewal prep time
90%
reduction in data entry errors
Full
audit trail for reinsurance reviews
100%
underwriter focus on decisions

Built for: Medical Captive Managers, Stop-Loss Carriers, Brokers

Explore a Pilot

Catch it before you pay it

Real-time pattern detection across claims data. Flags suspicious providers, duplicate submissions, and billing anomalies before they cost you money. Learns from your historical claims to get smarter over time.

Real-time
flagging (not post-payment audits)
Network-wide
pattern detection
Early
outlier identification
Seamless
integration with existing workflow

Built for: TPAs, Health Plans, Carriers

Explore a Pilot

From zero to automated in 4 weeks

1

Connect

We plug into your existing stack. EDI feeds, FHIR APIs, claims platforms, enrollment portals. No rip-and-replace.

2

Configure

We map your workflows, plan rules, and escalation paths. Agents learn how your team works, not the other way around.

3

Pilot

Go live with your team in the loop. 3-month pilot. Measure automation rates, accuracy, and cost savings together.

4

Scale

Add more agents. Automate more workflows. Your team handles the complex work. Agents handle the repetitive 70%.

In production today. Not a roadmap.

55%
automation rate (current customers)
40+
insurers served globally
$200K+
annual savings per customer
95%+
accuracy on eligibility and claims
5 years
of healthcare AI in production

"We replaced a 12-person offshore call center with Soteria's Support Agent. Member satisfaction went up. Costs went down 50%."

— TPA Operations Director

"Renewal prep used to take our team 3 weeks. Now it takes 2 days."

— Stop-Loss Operations Manager

Built by operators, not observers

Soteria AI is built by the team behind Curacel, a YC-backed insurtech that automated claims processing and fraud detection for 40+ insurers across Africa and the Middle East. We've processed millions of claims, handled compliance across 12 countries, and scaled to profitability.

We didn't see healthcare AI as a trend. We've been doing it for 5 years.

Henry Mascot

Founder & CEO: 2x founder (Curacel, Soteria), YC alumni, 5+ years healthcare AI

CTO Co-founder

Trained medical doctor turned product and engineering leader

Kevin Schlotman

Advisor: 20+ years TPA experience, former CCO at DISA, former President at Flume

Y

YC Alumni

HIPAA

HIPAA Compliant

SOC 2

SOC 2 Type II (in progress)

40+

Insurers Served

Built for how you actually operate

For TPAs

You manage self-funded employer health plans with thin margins. Every manual process eats into profitability. Support costs, enrollment backlogs, and renewal prep are bleeding resources.

Deploy: Support Agent + Plan Agent + Claims Agent. Start with the workflow that hurts the most.

For Health Plans

Member service quality that competes with national carriers, without their budgets. 24/7 support, instant eligibility, and compliance-guaranteed answers.

Deploy: Support Agent + Plan Agent. Your members get instant answers. Your compliance team gets audit trails.

For MGUs and Stop-Loss Carriers

Renewal season means weeks of manual work. Your underwriters spend more time formatting packets than analyzing risk.

Deploy: Renewal Ops Agent + Fraud Agent. Underwriters focus on decisions, not data entry.

For Insurtechs

You're building the next generation of payer infrastructure. You need AI that plugs into your stack, not another point solution.

Deploy: Any agent via API. White-label available. Build on our platform.

Explore a pilot in 4 weeks

Pick the workflow that slows your team down the most. We'll map where agents can help, what data is needed, and how to prove value fast.

  • • 4-week implementation
  • • 3-month pilot
  • • $5K-10K/month
  • • No long-term contract
  • • Implementation support included
Book a Pilot Call