Talent.com
This job offer is not available in your country.
Claims Clerk

Claims Clerk

Scry AIvapi, gujarat, in
11 hours ago
Job description

Position : Claims Clerk – Subject Matter Expert (SME)

Location : India (Remote)

Employment Type : Full-Time

Schedule : Monday to Friday, Day Shift

Experience : 2+ years in insurance / TPA claims operations with SME-level proficiency

Company Description

Scry AI is a research-led enterprise AI company that builds intelligent platforms to drive efficiency, insight, and compliance. Our platforms Collatio®, Auriga®, and Concentio® help insurers and TPAs automate document intake, validation, reconciliation and deliver real-time intelligence.

Role Overview

As a Claims Clerk (SME), you’ll be the go-to expert for end-to-end claims administration, standardizing intake, verification, and adjudication preparation while improving accuracy, turnaround time, and audit readiness. You’ll translate domain rules into clear SOPs, tagging schemas, and validation checklists that power Scry AI products (Collatio® for document intelligence and Auriga® for knowledge assistance), and you’ll coach the team on best practices.

Key Responsibilities

Operational Excellence & Governance

  • Own SOPs, checklists, and quality gates for claims intake, validation, and file preparation.
  • Define and maintain rules libraries (coverage, eligibility, deductibles, exclusions) and calculators.
  • Run QC audits, measure TAT / accuracy, and drive corrective actions and RCA / postmortems.

Claims Processing (SME Hands-On)

  • Review submissions; verify policyholder / provider data, coverage terms, and completeness.
  • Extract and validate structured fields (dates, amounts, codes); reconcile discrepancies.
  • Prepare adjudication-ready files; raise RFIs and track responses to closure.

    • AI / Automation Enablement

  • Partner with product / data teams to design field taxonomies, label policies, and validation rules.
  • Use Collatio® to auto-capture claim fields, BOM-like itemizations, and EOB details; validate outputs.
  • Curate ground-truth datasets and feedback loops to reduce extraction errors and false positives.

    • Compliance, Audit & Fraud Vigilance

  • Ensure documentation meets regulatory / privacy standards (IRDAI; HIPAA / GDPR as applicable).
  • Maintain audit trails, revision histories, and communication records.
  • Identify fraud / abuse indicators; escalate and document investigative notes.

    • Knowledge & Training

  • Create playbooks, macros / templates, and FAQ articles for Auriga® knowledge base.
  • Deliver training, shadowing, and certification paths for clerks / new hires.
  • Act as SME on customer calls, RFIs, and process transition / wrap-up meetings.

    • Required Qualifications & Skills

  • 2+ years in claims operations (health, motor, property) at an insurer / TPA / BPO.
  • Strong command of policy terms, EOBs; health lines : familiarity with CPT / ICD codes.
  • Proven record meeting TAT / accuracy targets; expert in documentation and QC.
  • Proficiency with spreadsheets, PDFs, claims / CRM systems; comfort with high-volume queues.
  • Excellent written / verbal communication; ability to convert domain rules into clear SOPs.

    • Nice to Have

  • Experience with AI / IDP tools (e.g., Collatio®) and rule-based adjudication engines.
  • Exposure to fraud frameworks and evidence handling.
  • Process improvement certifications (Lean, Six Sigma Yellow / Green Belt).

    • Our Ideal Candidate

  • Treats every claim as data : structured, validated, and audit-ready.
  • Uplifts teams through standards, training, and measurable quality improvements.
  • Comfortable collaborating with product / data engineers to make automation stick.

    • Tip for Candidates

    If this job opening excites you, follow our page to stay connected

    Create a job alert for this search

    Clerk • vapi, gujarat, in

    Related jobs
    • Promoted
    Referral Agent

    Referral Agent

    Immiigro Canada Immigration Centre Inc.vapi, gujarat, in
    Immiigro Canada Immigration Centre.Canadian government‑licensed immigration consultancy based in Toronto.College of Immigration and Citizenship Consultants (CICC). Canadian study permits, work permi...Show moreLast updated: 9 days ago
    • Promoted
    Majesco Billing Developer- Immediate Joiners

    Majesco Billing Developer- Immediate Joiners

    Stratusvapi, gujarat, in
    A Majesco Billing Center Developer specializes in building, configuring, and maintaining insurance billing solutions using the Majesco platform. This role is most common in organizations implementin...Show moreLast updated: 8 days ago
    • Promoted
    Senior Associate Australian Taxation

    Senior Associate Australian Taxation

    befree Globalvapi, gujarat, in
    Senior Associate Australian Taxation.Should have proficiency in year-end finalization of accounts and preparation of Tax. Returns for Companies, Partnerships, Trusts, ITR's, BAS etc.Work in Australi...Show moreLast updated: 23 days ago
    • Promoted
    • New!
    Revenue Operations Associate

    Revenue Operations Associate

    Scrut Automationvapi, gujarat, in
    Job Title : Revenue Operations Associate.Scrut Automation is a global leader in Governance, Risk, and Compliance (GRC).Our mission is to help modern enterprises move beyond simple checklists to buil...Show moreLast updated: 11 hours ago
    • Promoted
    Experienced Billing RCM

    Experienced Billing RCM

    My Care Internationalvapi, gujarat, in
    Experienced Billing RCM (Physicians / Hospital / Lab).My Care Labs is a leading laboratory specializing in wellness and toxicology testing, committed to providing accurate and timely results to support...Show moreLast updated: 30+ days ago
    • Promoted
    Senior Admisssion Counsellors- Study Abroad

    Senior Admisssion Counsellors- Study Abroad

    upGradvapi, gujarat, in
    A successful Admission Profiler excels in initiating contact with potential leads, thoroughly qualifying them, and cultivating genuine interest and necessity in upGrad’s programs and offerings.As a...Show moreLast updated: 22 days ago
    • Promoted
    • New!
    Senior Accounts Executive

    Senior Accounts Executive

    ELT Corporate Private Limitedvapi, gujarat, in
    BIS certification, NABL accreditation, CDSCO registration, EPR authorization, etc.We serve clients across manufacturing, healthcare, electronics, and environmental industries, helping them achieve ...Show moreLast updated: 3 hours ago
    • Promoted
    • New!
    Accounts Receivable Specialist

    Accounts Receivable Specialist

    SourceIN Solutionsvapi, gujarat, in
    Accounts Receivable & Collections.Follow up on overdue invoices and send payment reminders.Record customer commitments and maintain accurate payment records in ERP systems.Escalate unresolved or co...Show moreLast updated: 11 hours ago
    • Promoted
    Duck Creek Claims Developer (V10 or V11)

    Duck Creek Claims Developer (V10 or V11)

    Next Venturesvapi, gujarat, in
    Next Ventures are looking for a Duck Creek Claims Developer to join a Fully remote, 4-year implementation program which is due to start in 2 weeks. You'll need experience of both configuration and i...Show moreLast updated: 10 days ago
    • Promoted
    Guidewire Billing Developer

    Guidewire Billing Developer

    The AES Groupvapi, gujarat, in
    If you are passionate about Guidewire Billing and have strong hands-on development skills, this could be the right fit for you!. Guidewire development, including 3+ years in Guidewire Billing (Billi...Show moreLast updated: 10 days ago
    • Promoted
    • New!
    Transaction Processing Representative

    Transaction Processing Representative

    Mphasisvapi, gujarat, in
    Job Title : Transaction Processing Executive / Officer.DLF SEZ IT Park, Tower 1B, Level 1-5, 1 / 124, Shivaji Garden, Manapakkam, Mount Poonamalle Road, Chennai, Tamil Nadu 600089.Shift time : Complete...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    BA / QA (-Life Insurance / Annuity )

    BA / QA (-Life Insurance / Annuity )

    Skillveravapi, gujarat, in
    Life Insurance (Term / WL / UL) and Annuity insurance knowledge.End-to-end lifecycle experience of Product development and implementation on a policy administration platform. IT Business Analysis experi...Show moreLast updated: 11 hours ago
    • Promoted
    Collections Analyst

    Collections Analyst

    Branch Internationalvapi, gujarat, in
    Branch delivers world-class financial services to the mobile generation.With offices in the United States, Nigeria, Kenya, and India, Branch is a for-profit socially conscious company that uses the...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Underwriter

    Underwriter

    WNSvapi, gujarat, in
    The Mortgage underwriting associate evaluate and determine the eligibility of loan applications of residential mortgage 1 to 4 family loans. Mortgage underwriting associate role includes but not lim...Show moreLast updated: 11 hours ago
    • Promoted
    U.S. Tax Associate (Remote) (Entry-Level)

    U.S. Tax Associate (Remote) (Entry-Level)

    Jayakumar Lawvapi, gujarat, in
    Remote
    Tax Associate (Entry-Level | CA Inter | INR ₹7–7.Remote (India-based candidates only).Multiple remote full-time roles.CA Inter-qualified candidates (via direct entry route).CPA firms with tax prepa...Show moreLast updated: 30+ days ago
    • Promoted
    Loan Processor (Australia)

    Loan Processor (Australia)

    Global Assistvapi, gujarat, in
    Welcome to Global Assist (GA)! At GA, we specialize in providing offshore staffing solutions to businesses across various industries, including mortgage broking, accounting, taxation, and other bus...Show moreLast updated: 30+ days ago
    • Promoted
    Administrative and Accounting Assistant

    Administrative and Accounting Assistant

    ALIANDOvapi, gujarat, in
    Administrative And Accounting Assistant.Working Hours - 12 : 30 PM to 9 : 30 PM IST .ALIANDO is an award-winning Azure Expert Managed Service solutions company focused on selling and deploying Microsof...Show moreLast updated: 15 days ago
    • Promoted
    Insurance Specialist

    Insurance Specialist

    Scry AIvapi, gujarat, in
    Insurance Specialist (SME – Claims, Underwriting & Compliance).Years in Insurance Operations, Claims Management, or Underwriting (experience with AI-driven insurance or digital tools preferred).Scr...Show moreLast updated: 3 days ago