Insurance Partner Integrations

Overview

New pharmacy-benefit partners exposed different request models, response formats, and asynchronous behaviors. The existing claim path was not designed to absorb those differences cleanly, and failure recovery often required manual attention.

What I Did

I implemented two production partner integrations and the supporting claim submission, reversal, retry, and observability workflows needed to operate them reliably.

• Isolated partner-specific request translation and response mapping behind stable internal contracts.
• Supported both immediate API responses and asynchronous webhook completion.
• Added automated retry state and workflow integration for recoverable failures.
• Applied partner-level throttling to protect external APIs and internal workers.
• Built monitoring for claim outcomes and operational investigation.

Engineering Decisions

External integrations should not leak every partner variation into the product. A translation boundary kept the internal workflow stable while explicit retry and rate controls handled the realities of third-party systems.

Outcome

The integrations added approximately 323,000 insurance claims per month across two new partners while preserving a consistent operating model for submission, reversal, and failure handling.