Throughout his career, Kartheek has held key positions at CareFirst BlueCross BlueShield (BCBS), Asurion Insurance Services, and a leading financial institution. His work in these organisations has focused on devising and integrating tech-driven solutions to tackle operational inefficiencies.

One of Kartheek’s most notable achievements was at CareFirst BCBS, a leading health insurance provider, where he revolutionised claims processing. “By utilising Pega's decision-making platforms, we embedded dynamic rules into claims procedures,” he shares. “This led to a 35% reduction in processing time, significantly enhancing efficiency and customer satisfaction.”

At Asurion Insurance Services, Kartheek spearheaded the implementation of Horizon, a mobile solutions platform designed to simplify claims processing. “We achieved a 30% reduction in processing time, which was instrumental in improving service delivery,” he notes.

Beyond claims automation, Kartheek’s expertise extends into AI-driven fraud detection. At a prominent financial institution, he implemented decision models that improved detection accuracy to 90% while reducing false positives. “The integration of AI in compliance checks enhanced fraud prevention and bolstered the organisation’s security framework,” he explains.

Kartheek’s contributions also include designing intelligent automation workflows that resulted in annual savings of over 30 Full-Time Equivalents (FTEs) and a 40% decrease in manual processing. Additionally, at Pega Systems India Pvt Ltd, he played a key role in developing a Customer Process Management for Insurance (CPMI) system. “This scalable system supported a 40% increase in customer interaction value, demonstrating the potential of digital process automation,” he adds.

Certified as a Project Management Professional (PMP) and a SAFe Certified Practitioner, Kartheek seamlessly navigates projects with Agile principles. His ability to manage projects efficiently and collaborate with teams has been a cornerstone of his success.

However, these achievements did not come without challenges. “At CareFirst BCBS, we had to overcome legacy system limitations while integrating dynamic claims workflows,” he recalls. “Deploying AI-powered fraud detection at the financial institution also presented integration complexities, while data inconsistency was a hurdle during the Horizon platform rollout at Asurion.”

Kartheek actively shares his knowledge through blogs, whitepapers, and contributions to internal knowledge-sharing platforms. He believes that AI and machine learning are poised to reshape claims processing by enabling predictive analytics and real-time decision-making. “Automation tools like Pega RPA are becoming indispensable for achieving efficiency and accuracy in claims workflows,” he states.

As the insurance industry evolves, security and compliance remain top priorities. “Investing in AI-driven compliance tools will help mitigate risks and enhance transparency,” Kartheek advises. “A collaborative approach between IT and business teams is key to identifying and implementing impactful automation opportunities.”

Kartheek’s dedication to technological innovation is shaping the future of claims processing. His work serves as a testament to how intelligent automation can drive efficiency, improve customer experiences, and deliver tangible business outcomes.