Bengaluru, Karnataka
Job Summary

Role Summary

Responsible for defining end-to-end business processes for AI-enabled Claims solutions, ensuring AI outputs are effectively integrated into operational workflows. The role focuses on translating business needs into AI requirements, defining exception handling, human-in-the-loop processes, and ensuring AI-generated insights can be operationalized within production environments.

Key Responsibilities
Analyze end-to-end Claims processes and identify opportunities for AI-driven automation and decision support.
Define how AI outputs will be consumed within business workflows, applications, and operational processes.
Establish business rules for AI-generated decisions, recommendations, and document extraction outcomes.
Design exception handling, escalation paths, and human-in-the-loop workflows for low-confidence or ambiguous AI results.
Define AI confidence thresholds, review mechanisms, and operational controls in collaboration with business and technical teams.
Document current-state and future-state process flows, including AI touchpoints and manual intervention scenarios.
Create business requirements, user stories, acceptance criteria, and process maps for AI solutions.
Define business validation criteria, ground truth expectations, and success metrics for AI use cases.
Support UAT, business testing, and model validation activities.
Work across multiple LBUs to harmonize AI-enabled business processes and identify reusable patterns.
Track adoption, business outcomes,



and value realization of post-deployment.
Skill Requirements
5+ years of Business Analysis experience.
Strong Insurance Claims domain expertise across Claims Intake, Assessment, Adjudication, Payments, and Claims Operations.
Experience working on AI, GenAI, Intelligent Automation, or Digital Transformation initiatives.
Strong understanding of workflow design, business rules, exception management, and operational processes.
Experience defining human-in-the-loop and AI-assisted business processes.
Solid stakeholder management and requirements elicitation skills.
Experience working in Agile delivery environments.

Preferred Experience

Experience implementing Claims AI, IDP, RAG, or Agentic AI solutions.
Understanding of AI confidence scoring, AI evaluation concepts, and business validation frameworks.
Experience defining operational processes for AI-generated outputs and exception management.

Key Selection Criteria

Strong understanding of how to operationalize AI outputs within Claims processes.
Proven experience defining exception handling and human-review workflows.
Ability to bridge business operations, AI capabilities, and production processes.
Experience designing end-to-end AI-enabled operating models rather than only gathering requirements.

Other Requirements
#body.unify div.unify-button-container .unify-apply-now: focus, #body.unify div.unify-button-container .unify-apply-#body.unify div.unify-button-container .unify-apply-now: focus, #body.unify div.unify-button-container .unify-apply-

📌 Lead Business Analyst (India)
🏢 HCLTech
📍 India