- Location
- Pune
- Type
- Full-time
- Experience
- 5+ years
- Education
- Master
- Source
- Pinpoint
Description
Domain Expert
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
Skills
UnderwritingComplianceHIPAA
