Domain Expert

Davies; Pune District; On-site; INR 1,200,000 - 2,000,000; Full time

Job summary

A leading insurance company is seeking a Domain Expert in Life & Health to oversee teams in claims processing and quality management. This role requires 5–10+ years of U.S. Life & Health insurance experience and strong regulatory compliance knowledge. Responsibilities include providing guidance on insurance products, defining business requirements, and collaborating with cross-functional teams. Candidates should possess excellent analytical and communication skills, along with a Bachelor's or Master's degree and relevant insurance certification.

Qualifications

• 5–10+ years of experience in U.S. Life & Health insurance.
• Deep domain expertise and regulatory awareness.
• Ability to translate business needs into clear functional requirements.

Responsibilities

• Provide expert guidance on Life & Health products.
• Interpret and apply U.S. regulatory frameworks.
• Define and validate business requirements for system enhancements.

Skills

U.S. Life & Health insurance experience

Strong analytical skills

Regulatory compliance knowledge

Cross-functional collaboration

Strong communication skills

Problem-solving ability

Attention to detail

Education

Bachelor or Masters

Insurance certification

Job description

Department: Business Support

Employment Type: Permanent - Full Time

Location: Pune

Description

We are looking for a proactive and detail‑oriented Domain Expert – Life & Health to oversee the multiple teams responsible for processing L&H & US Insurance. The role will involve domain management, trainings, quality monitoring, process compliance, and liaising with stakeholders to process claims, team productivity, and alignment with client‑specific requirements. The Domain Expert will support coaching, reporting, escalations, and operational improvement initiatives.

Key Responsibilities

• Provide expert guidance on Life & Health products: Term/Whole/UL Life, Group Health, Medicare/Medicaid, ACA plans, Disability, Critical Illness, Supplemental Health.
• Interpret and apply U.S. regulatory frameworks including NAIC, HIPAA, ACA, ERISA, state‑specific rules. Improve end‑to‑end processes: new business, underwriting, policy issuance, servicing, billing, claims, renewals.
• Define and validate business requirements for system enhancements, automation, and digital transformation.
• Collaborate with actuarial, compliance, operations, IT, and product teams to ensure alignment.
• Analyze operational and claims data to identify trends, risks, and improvement opportunities.
• Review policy forms, customer communications, and process documentation for accuracy and compliance.
• Provide training, domain knowledge sessions, and SME support for cross‑functional teams.

Skills, Knowledge & Expertise

• 5–10+ years of experience in U.S. Life & Health insurance.
• Strong understanding of underwriting, claims, product structures, and regulatory compliance.
• Experience with policy administration, underwriting, or claims systems.
• Ability to translate business needs into clear functional requirements.
• Strong analytical, documentation, and communication skills.
• Bachelor or Masters Preferred GB and Lean certified
• Insurance certification
• Deep domain expertise and regulatory awareness.
• Process optimization and problem‑solving ability.
• Cross‑functional collaboration and stakeholder management.
• High attention to detail and strong business acumen