Rubraik Automate, agentic AI for regulated operations
Agents that work the case, not just the click
Rubraik Automate deploys AI agents that read the case, decide what it needs, act across your systems, and bring a person in at the points that require judgment. Built for healthcare, insurance, financial services, and utilities, where accuracy and auditability decide whether automation is allowed to run at all.
The work behind the work, automated and governed
Legacy RPA breaks when processes change. RCX Rubraik Automate takes a different approach: AI agents that understand context, navigate exceptions, and complete multi-step work across contact center and back office operations — moving data between systems, processing documents, updating records, and closing cases from end to end. Agents act across your existing systems, including legacy applications, with no rip-and-replace project.Â
Every action runs inside a governed framework with full auditability, enforced policies, and human oversight at the points that matter. Your teams focus on decisions and relationships; automation scales in regulated operations while control stays firmly in place.Â
Why agentic changes
what you can automate
Rules-based automation handles the path you predicted. Regulated work is mostly the paths you did not.
What rules-based automation does
- Follows a fixed sequence and stops when the screen changes.
- Needs every exception mapped in advance by a developer.
- Reads structured fields and fails on a fax, a scan, or a free-text note.
- Breaks when a plan rule, a state requirement, or a form version changes.
- Reports what it ran rather than what it achieved.
What an agent does instead
- Reads the case, works out what it needs, and chooses the next action.
- Handles exceptions it has not seen before by reasoning from your policy.
- Interprets unstructured documents, correspondence, and notes.
- Adapts when rules change, because it works from the policy rather than a script.
- Stops and escalates when confidence is low or a regulated decision is due.
Where agents earn their place in regulated work
Not pilots. These are the processes where the volume is high, the rules are strict, and the manual cost is largest.
Prior authorization preparation
Agents intake requests from any channel, verify eligibility and network status, test documentation against medical policy, and chase what is missing before a reviewer sees the case.
Claims inquiry and correction
Agents trace a claim through adjudication, identify why it denied, distinguish a coding issue from an eligibility issue from a coordination of benefits issue, and prepare the correction for approval.
Grievance and appeal casework
Agents classify the case type, apply the correct regulatory clock, assemble the full history across systems, draft the acknowledgement, and track every deadline to closure.
Enrollment and eligibility processing
Agents validate applications, reconcile discrepancies against state and federal files, resolve routine mismatches, and route genuine conflicts to a person with the evidence attached.
Provider directory validation
Agents contact practices, confirm address, panel status, and accepting-new-patients data, and update the directory continuously rather than in an annual sweep.
Care gap and Stars follow-through
Agents identify open gaps, reach members and providers, schedule what needs scheduling, and confirm completion in the record rather than logging an attempt.
What the agents can do
Reason
- Interprets unstructured documents, correspondence, and clinical or claims notes.
- Decides what a case needs rather than following a fixed branch.
- Works from your policies, so a rule change updates behavior without a rebuild.
- Recognizes when it is uncertain and says so instead of guessing.
Act
- Runs multi-step processes end to end, around the clock.
- Operates across CRMs, core platforms, and legacy applications with no rip-and-replace project.
- Reaches out to members, customers, and providers to unblock a case.
- Classifies, routes, and orchestrates work against intents and service levels.
Stay accountable
- Escalates regulated decisions and low-confidence cases to a named person.
- Logs every action, source, and decision point with timestamps.
- Masks sensitive data and holds least-privilege access in every workflow.
- Reports automation rate, accuracy, and outcome, not bot counts.
Built on the strongest parts of the automation ecosystem
We assemble proven platforms rather than asking you to bet on one vendor’s roadmap.
Reasoning and judgment
Frontier language models interpret documents, weigh cases against policy, and decide what happens next.
Enterprise process automation
Established RPA and desktop automation reach the systems that have no API, including the ones nobody wants to touch.
Conversational execution
Voice and digital agents carry the outreach that unblocks a case, in the customer's language and channel.
Case and service management
Workflow and service platforms hold the case, the queue, the service level, and the audit record.
Reasoning and judgment
Frontier language models interpret documents, weigh cases against policy, and decide what happens next.
Enterprise process automation
Established RPA and desktop automation reach the systems that have no API, including the ones nobody wants to touch.
Conversational execution
Voice and digital agents carry the outreach that unblocks a case, in the customer's language and channel.
Case and service management
Workflow and service platforms hold the case, the queue, the service level, and the audit record.
The orchestration layer is ours, and it is what turns four platforms into one accountable process. That layer is also what we tune in production, because the model choice matters far less than knowing which step should never be automated.
Impact you can measure
Lower cost to serve
The manual assembly work behind every case comes off the human queue.
Faster cycle times
Cases move overnight and across shifts instead of waiting for a queue to open.
Elastic capacity
Enrollment periods and storm events absorb without a temporary workforce.
Governed compliance
Turnaround windows and audit trails hold because the process enforces them.
How we make it real
We take a three-step approach to automating processes, giving hundreds of hours back to decision-makers and allowing them to focus on what matters most — delighting your customers.Â
What sets us apart
Compliance and audit trails are native to every agent, because the product was designed for regulated environments from the start.
Delivery is measured on cost, quality, and experience outcomes rather than on how many bots are running.
Thirty years of operations expertise means we automate the process as it actually runs, including the workarounds nobody documented.
Analyze finds the opportunity, Automate puts it into production, and Audit assures every action taken.
Ten capabilities, connected at every level
RCX Rubraik Assist
RCX Rubraik Automate
RCX Rubraik Analyze
RCX Rubraik Audit
RCX Rubraik Ascend
RCX Rubraik Achieve
RCX Rubraik Access
RCX Rubraik Animate
RCX Rubraik Advise
Consulting and strategic advisory that turns AI output into operating strategy.
