KGiSL - Subject Matter Expert - Healthcare Domain (15-22 yrs)

We invite you to consider the excellent opportunity as a "Subject Matter Expert" to grow your experience and expertise with our Insurance Team at KGiSL.

Do you want to work onsite, while also being part of a smart tech colleagues working across locations? If yes, go ahead and learn more about this exciting opportunity!

Job Title : Health Insurance & Healthcare (Payer/Provider) Domain SME

Location : Coimbatore, India

Job Summary :

We are looking for a highly skilled Subject Matter Expert (SME) in Health Insurance & Healthcare (Payer/Provider) to join our team in Coimbatore. The ideal candidate should have a minimum of 15 years of domain experience across India, APAC, the Middle East, US, and Europe markets, along with at least 5 years of hands-on experience in IT services or Health Insurance/Healthcare IT Product/Platform industry. Industry-recognized certifications in health insurance, healthcare, or IT platforms are required.

Key Responsibilities :

Domain Expertise & Consulting :

- Provide expert insights into health insurance products, healthcare payer/provider processes, and market trends across multiple geographies.

- Analyze business requirements and translate them into IT solutions aligned with industry best

practices.

- Collaborate with stakeholders to improve business processes, claims management, underwriting, and provider network operations.

IT Services & Product/Platform Expertise :

- Work closely with IT teams to design, develop, and implement health insurance and healthcare technology solutions.

- Contribute to the enhancement of healthcare payer/provider platforms and products with domain expertise.

- Support pre-sales, solutioning, and proposal development by providing domain insights

Regulatory & Compliance Advisory :

- Stay updated on health insurance regulations, compliance standards, and government

policies across different regions.

- Ensure IT solutions and business processes adhere to regulatory requirements like HIPAA, ICD10, HL7, FHIR, IRDAI, CMS, and GDPR (depending on geography).

- Provide risk assessment, policy framework development, and compliance reporting support.

Training & Knowledge Management :

- Conduct training sessions, workshops, and knowledge-sharing initiatives for internal teams and clients.

- Develop domain-specific documentation, best practices, and case studies.

Required Qualifications & Experience :

Experience :

- Minimum 15 years in the Health Insurance & Healthcare (Payer/Provider) domain.

- 5+ years in IT services or Health Insurance/Healthcare IT Product/Platform industry.

Certifications (Preferred) :

- AHIP (Americas Health Insurance Plans)

- LOMA (Life Office Management Association) - Health Insurance modules

- HIPAA, ICD-10, HL7, FHIR certifications

- Certified Health Insurance Specialist (CHIS) or equivalent

Geographical Exposure :

- Experience with health insurance & healthcare businesses in India, APAC, Middle East, US, or Europe.

IT & Digital Expertise :

- Experience in healthcare digital transformation, insurtech solutions, or payer/provider platforms.

- Familiarity with claims adjudication systems, policy administration systems, AI-driven

healthcare applications, and automation.

Skills :

- Strong analytical, problem-solving, and consulting skills.

- Excellent communication, stakeholder management, and client interaction abilities.

- Ability to work cross-functionally with IT, business, and compliance teams.

Preferred Qualifications :

- Knowledge of population health management, revenue cycle management (RCM), value-base care, and interoperability standards.

- Experience with cloud-based health insurance solutions, AI/ML in healthcare, and predictive analytics.

- Hands-on experience in Agile, DevOps, or SaaS-based healthcare solutions.

This role offers a dynamic and impactful opportunity for professionals looking to leverage their healthcare domain expertise in a technology-driven insurance & healthcare ecosystem.

About Us :

KGiSL is a BFSI centric multiproduct Enterprise Software company focused on Banking, Insurance, Capital Markets, & Wealth Management segments. KGiSL by roots believe in being empathetic to customers and offering products and services that deliver incremental business outcome. Harnessing the power of Machine Learning (ML), Artificial Intelligence (AI), Analytics, Data Science and Cloud to empower our clients through our products and deliver Empathy based Outcomes backed by next Generation Customer Experience.

As a leader in providing Fintech solutions, some of the biggest names from the insurance, banking and financial industry in the APAC regions trust our products & solutions. We are recognized by our customers for the comprehensive portfolio of products and for the value that reflects our commitment towards their success. With over 1500+ professionals, KGISL has offices in India, USA, Singapore, Malaysia, Australia and Thailand. Our continuous learning and the approach to upskilling talents have accelerated our drive to deliver innovative solutions that address real-time challenges.

Company size : 1,001-5,000

Industry : Software Development

Specialities :

Software services, Analytical Services, Machine Learning, IT Services, BFSI Technology Services, Fintech, Automation Services, Solution Based Services, Professional Services, Application development, and Infrastructure Management