NEXUS
Premium Audit Intelligence
Live
PA
Premium Audit Data Intelligence · Version 2.0
Transforming Premium Audit into a Real-Time AI-Powered Profit Centre
NEXUS unifies fragmented payroll, claims, regulatory and third-party data into a single governed data intelligence platform — enabling AI-driven audit automation, proactive leakage detection, and actuarial-grade decision support across Workers Compensation and General Liability lines.
Platform Status
Phase 2 Active
Month 8 of 24
$0M
Leakage Recovered
0+
Audit Cases
0%
Target STP Rate
0%
AI Model Accuracy
0 days
Target Cycle Time
$0M
3-Yr NPV
Five Strategic Pillars
🏗️
Unified Data Foundation
Single governed data lake consolidating all internal and third-party premium audit data sources under a unified taxonomy.
Data sources24 connected
Tables140+
Data quality94% target
72% complete
🤖
AI-Powered Intelligence
Machine learning models for payroll classification, EMod verification, OSHA reconciliation, and anomaly detection.
AI models12 in production
Accuracy97.8%
Auto-resolved42%
58% complete
⚡
Process Automation
Straight-through processing for qualifying audits, automated document ingestion, and AI-assisted exception management.
STP rate (current)31%
STP rate (target)68%
Cycle time47→19 days
40% complete
⚖️
Regulatory Excellence
Real-time integration with NCCI, state WC boards, ISO, and OSHA — ensuring always-current regulatory data for every audit.
States covered48 + DC
NCCI states38 live
Compliance score99.1%
85% complete
📈
Continuous Learning
Closed-loop feedback between audit outcomes and model retraining — driving continuous improvement in prediction accuracy.
Model refreshWeekly
Feedback loops6 active
Improvement rate+0.4%/qtr
25% complete — Phase 4
Data Maturity Assessment
Current State 24-Month Target
Technology Ecosystem
Current State vs. Target State — Key Audit Metrics
MetricCurrent24-Mo TargetAnnual Impact
Integrated Data Architecture — At a Glance
Data Sources
🏢 PolicyCenter
💰 BillingCenter
📋 ClaimsCenter
📐 NCCI Connect
💼 ADP Payroll
🦺 OSHA Records
+18 more →
Azure Data Factory · MuleSoft
❄️
Snowflake
Multi-layer
Data Lake
Databricks · Azure ML
AI Outputs
🤖 SENTINEL (WC)
🤖 MERIDIAN (GL)
📊 Analytics Hub
⚡ BillingCenter
📈 Executive BI
Transformation Roadmap · 24 Months
From Fragmented Data to Intelligent Audit — A Phased Approach
Four progressive phases delivering cumulative value — from data lake foundation through AI automation, real-time processing, and finally self-service predictive analytics. Each phase builds on the last with clear gates, success criteria, and measurable ROI.
Month 8
Current Position
$18.4M
Total Programme Budget
1
Phase 1
Foundation
Months 0–6 · $4.2M
Data lake architecture, core API integrations, data taxonomy, governance framework, and team onboarding.
✓ Complete100%
2
Phase 2
Intelligence
Months 7–12 · $5.8M
AI/ML model deployment, STP automation for WC and GL, SENTINEL and MERIDIAN platform integration.
⟳ In Progress33%
3
Phase 3
Scale
Months 13–18 · $5.1M
Real-time streaming, multi-state NCCI expansion, advanced payroll analytics, and predictive EMod alerts.
Not started0%
4
Phase 4
Excellence
Months 19–24 · $3.3M
Self-service analytics, market intelligence integration, closed-loop model optimization, and executive AI dashboards.
Not started0%
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Workstream Gantt — 24 Months
Platform & Infra Data Ingestion AI / ML Process & UX Change Mgmt Governance
Key Milestones
Budget Allocation by Phase
Investment Breakdown
Data Lake Architecture · Snowflake Multi-Layer
Premium Audit Data Lake — Bronze to Platinum
A four-zone architecture ingesting data from 24+ internal and external sources, progressively cleansing and enriching data until it is audit-ready and AI-model-ready. Every field is taxonomy-tagged per the PA Data Dictionary v3.0.
Data Source Interaction — Click any node or connection to view integration detail
Internal → Lake
External → Lake
Active feed
Data Lake Zones — Click to explore tables and schema
🥉 Bronze
RAW INGESTION
Exact copies of source data. Schema-on-read. No transformation. Full provenance tracking. Immutable append-only storage.
PA_BRONZE schema · 4.8TB · 58 tables
ADP 941 Raw NCCI Unit Stat OSHA 300 PDFs Policy XML Claims JSON
⏱ Latency: <5 min 📥 30K+ records/day
🥈 Silver
CLEANSED & STANDARDIZED
Validated, deduplicated, standardized. Address normalization, EIN matching, taxonomy tagging. AI exception routing.
PA_SILVER schema · 3.1TB · 44 tables
Payroll Validated Claims Dedupe EMod Verified OSHA Reconciled
⏱ Latency: <30 min ✅ 94% data quality
🥇 Gold
AUDIT-READY CURATED
Business logic applied. WC EMod calculations, GL class code mappings, payroll variance computations. Audit-decision-ready.
PA_GOLD schema · 2.2TB · 28 tables
WC Audit Case GL Exposure Basis Premium Calc Leakage Flag
⏱ Latency: <2 hrs 🎯 Audit-ready STP
💎 Platinum
AI / ANALYTICS LAYER
Feature store for ML models. Pre-aggregated analytics. Real-time scoring tables. Executive BI feeds. Model performance tracking.
PA_PLATINUM schema · 1.8TB · 22 tables
ML Features Risk Scores Audit Insights Executive KPIs
⏱ Latency: Real-time 🤖 12 models served
Integration Patterns & SLAs
Data Volume & Velocity
PA Data Dictionary v3.0 — Taxonomy Coverage
Sample Taxonomy Entries (Click to view definition)
Risk & Governance · Programme-Level
Risk Management & Data Governance Framework
A comprehensive DAMA-DMBOK aligned governance model with proactive risk identification, structured mitigation strategies, and continuous compliance monitoring across all 24 data sources and 4 lake zones.
Risk Heat Map — Likelihood × Impact
Likelihood →
Impact →
Low Med High Critical
Low Moderate High Critical
Risk Summary by Category
Risk Register — Click any risk for mitigation detail
Category & Risk Description Score Status Owner
Data Governance Framework — DAMA-DMBOK Aligned
Data Quality Dashboard — Live
Regulatory Compliance Checklist
Value Realization · 3-Year Business Case
Total 3-Year Net Present Value
$0M
Based on $18.4M programme investment · 16-month payback · IRR 147%
16 Months
Investment Payback Period
147%
Internal Rate of Return
Cumulative Benefit vs. Investment ($M)
Annual Benefit by Category ($M)
Value Drivers — Detail
Interactive ROI Scenario Modeller
Adjust Assumptions
Projected Outcomes
Capability Improvement — Current vs Target
Industry Benchmarking