enGen’s AI Cognitive Engine resolved 2.19 million claim suspensions last year at 99.64 percent accuracy. The architect behind the system says the math was the easy part.
In May 2025, an awards program most people outside the healthcare technology industry have never heard of named enGen’s AI Cognitive Engine the best core administrative processing system of the year. The MedTech Breakthrough panel drew nominations this year from companies in more than 18 countries. The announcement carried on GlobeNewswire on May 8, 2025, ran short. The numbers behind it did not.
ACE, as the engine is branded, addresses more than 3 million claim suspensions a year. Cumulative savings across use cases have exceeded $10 million. The Claims Examiner platform, the system’s adjudication component, resolves 2.19 million suspensions annually at 99.64 percent accuracy, with projected cost savings of roughly $1.07 million per client per year and resolution about 50 percent faster than manual processing. When the AI and a human examiner disagree on a claim, enGen’s published figures show the AI to be the more accurate party 90 percent of the time.
ACE was built inside enGen, the technology operating company of Highmark Health, the Pittsburgh-based integrated health and finance organization that insures roughly 6.9 million members and employs about 44,000 people. enGen itself serves health plans and providers covering more than 20 million members nationwide and employs more than 11,000 people. The named technical figure in the company’s award materials is Rahul Awasthy, the company’s Lead (Principal) Solution Architect. Awasthy holds a Ph.D. in data science, an MBA, and an AWS Solution Architect certification. At enGen, he runs a 25-plus member global team responsible for delivery of the company’s digital health solutions, operating inside a 40-plus member Blueprint team that sets architectural standards across the product ecosystem. He worked alongside teams from Deloitte, Accenture, and the company’s internal engineering organization on ACE’s core architecture, and represented enGen as a technical subject-matter expert at Google Cloud Next 2025.
