We are seeking a proactive and detail-oriented Domain Expert to oversee multiple teams responsible for processing Life & Health and US Insurance claims. The successful candidate will provide expert guidance on Life & Health products, interpret and apply US regulatory frameworks, and define business requirements for system enhancements.
Key Responsibilities
Provide expert guidance on Life & Health products including Term/Whole/UL Life, Group Health, Medicare/Medicaid, ACA plans, Disability, Critical Illness, and Supplemental Health.
Interpret and apply US regulatory frameworks such as NAIC, HIPAA, ACA, ERISA, and state-specific rules to improve end-to-end processes.
Define and validate business requirements for system enhancements, automation, and digital transformation.
Collaborate with actuarial, compliance, operations, IT, and product teams to ensure alignment.
Analyse 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 US 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 degree preferred.
GB and Lean certified.
Insurance certification.
Deep domain expertise and regulatory awareness.
Process optimisation and problem-solving ability.
Cross-functional collaboration and stakeholder management.
High attention to detail and strong business acumen.
