Canada
Puerto Rico
USA
Belgium
France
UK
India
Client Background
A leading not-for-profit health insurer serving millions across New York’s diverse and underserved communities, delivering Medicaid, Medicare Advantage, and Commercial plans through a broad provider network.
Client Need
Multiple payment systems across channels causing operational silos
Manual payment exception handling leading to delays and customer complaints
Lack of end-to-end payment visibility and tracking.
High operational cost due to fragmented payment workflows
Difficulty supporting multiple payment rails (ACH, SWIFT, RTP, FedNow, Wires)
Regulatory and compliance requirements increasing complexity
Inconsistent customer experience across payment channels
Limited real-time monitoring and alerting capabilities
Challenges integrating legacy payment systems with modern platforms
Need for scalable architecture supporting future payment innovations
Solution
Designed and implemented a centralized Payment Hub using Pega Infinity
Built a reusable payment orchestration framework supporting multiple payment types, configurable routing rules, and intelligent payment prioritization
Implemented case management-driven payment lifecycle tracking
Developed a reusable integration framework using Pega Connectors and Services, integrating REST, SOAP, MQ, Kafka, File-based interfaces, and AML, Fraud, and Sanctions screening systems
Enabled STP for low-risk transactions while implementing intelligent exception handling, SLA-based monitoring, escalations, and role-based work queues for Operations, Compliance, and Investigations teams
Implemented comprehensive audit trails and compliance reporting capabilities
Enabled deployment on Pega Cloud with scalable microservice integrations
Realized Benefits
Reduced payment processing turnaround time by 60%
Increased STP from 65% to 92%, reducing manual effort
Enabled real-time payment visibility and proactive customer status updates
Accelerated exception resolution while improving SLA adherence and reducing investigation backlog
Reduced payment failures through intelligent validation and routing
Strengthened compliance with end-to-end auditability and traceability
Accelerated onboarding of new payment channels and rails
Scaled operations with a reusable enterprise payment framework supporting future modernization and transaction growth
Tools & Technologies
Python
PostgreSQL
AWS
ECS Fargate/EKS
Amazon S3
Amazon RDS
DynamoDB
Amazon SQS
EventBridge
Step Functions
CloudWatch
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