Talent.com
Claims Clerk

Claims Clerk

Scry AIrajkot, gujarat, in
8 days 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 • rajkot, gujarat, in

    Related jobs
    • Promoted
    BA / QA (-Life Insurance / Annuity )

    BA / QA (-Life Insurance / Annuity )

    SkillveraRajkot, 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: 8 days ago
    • Promoted
    Specialist - Privacy Implementation

    Specialist - Privacy Implementation

    Baldor Technologies Private Limited (IDfy)Rajkot, IN
    IDfy is Asia’s leading TrustStack, trusted by the best, with global expertise and enterprise-grade tech, we’re solving trust challenges, making compliance easy,fraud detection smarter, and onboardi...Show moreLast updated: 8 days ago
    • Promoted
    Majesco Billing Developer- Immediate Joiners

    Majesco Billing Developer- Immediate Joiners

    StratusRajkot, 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: 22 days ago
    • Promoted
    Duck Creek Claims Developer (V10 or V11)

    Duck Creek Claims Developer (V10 or V11)

    Next VenturesRajkot, 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: 18 days ago
    • Promoted
    Guidewire Billing Developer

    Guidewire Billing Developer

    The AES GroupRajkot, 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: 18 days ago
    • Promoted
    Repurchase specialist

    Repurchase specialist

    Deloitterajkot, gujarat, in
    Every day, your work will make an impact that matters, while you thrive in a dynamic culture of inclusion, collaboration and high performance. As the undisputed leader in professional services, Delo...Show moreLast updated: 27 days ago
    • Promoted
    • New!
    Contract-IT Purchasing Specialist –(ITSM / Software / Hardware)

    Contract-IT Purchasing Specialist –(ITSM / Software / Hardware)

    KPG99 INCRajkot, IN
    Job Title : IT Purchasing Specialist –(ITSM / Software / Hardware).Location Offshore Remote (India)-Must be in India.Duration : Through 2025 with 1 year extension after that. Must Haves (need to be highli...Show moreLast updated: 11 hours ago
    • Promoted
    Insurance Specialist

    Insurance Specialist

    Scry AIrajkot, 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: 11 days ago
    • Promoted
    Guidewire BillingCenter Developer

    Guidewire BillingCenter Developer

    HTC Global Servicesrajkot, gujarat, in
    Troy, Michigan, is a leading global Information Technology solution and BPO provider.HTC assists clients across multiple industry verticals, offering turnkey project lifecycle in, e-business, data ...Show moreLast updated: 16 days ago
    • Promoted
    Pricing Specialist - (USA)

    Pricing Specialist - (USA)

    PlattonRajkot, IN
    Pricing Specialist – Ocean / Air / Drayage & Multimodal Freight (U.Our services include air and ocean freight forwarding, customs brokerage, contract logistics, warehousing and distribution, truckl...Show moreLast updated: 1 day ago
    • Promoted
    Accounts Receivable Manager

    Accounts Receivable Manager

    HireGenie | Finance Recruitment ExpertRajkot, IN
    Accounts Receivable Manager - Remote.We are seeking a highly skilled.The ideal candidate will possess deep expertise in managing global receivables, credit risk assessment, revenue reconciliation, ...Show moreLast updated: 4 days ago
    • Promoted
    Accounts Receivable Specialist

    Accounts Receivable Specialist

    SourceIN Solutionsrajkot, India
    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: 1 day ago
    • Promoted
    • New!
    Carrier Claim Specialist

    Carrier Claim Specialist

    BolsterBizRajkot, IN
    BolsterBiz is a leading provider of offshoring and outsourcing services based in New Delhi.We specialize in driving business growth, optimizing operational efficiency, and ensuring long-term succes...Show moreLast updated: 11 hours ago
    • Promoted
    Trade operations - Bill Booking and LC Handling

    Trade operations - Bill Booking and LC Handling

    MizuhoRajkot, IN
    Mizuho Global Services India Pvt.Mizuho Global Services Pvt Ltd (MGS) is a subsidiary company of Mizuho Bank, Ltd, which is one of the largest banks or so called ‘Mega Banks’ of Japan.MGS was estab...Show moreLast updated: 8 days ago
    • Promoted
    Collections Analyst

    Collections Analyst

    Branch Internationalrajkot, 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
    Actuarial Life Pricing

    Actuarial Life Pricing

    EliteRecruitmentsrajkot, India
    Ideal for professionals with hands-on experience in individual life product pricing, model development, and IRDAI filing. Conduct feasibility studies for.Collaborate with cross-functional teams incl...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Contract Specialist

    Contract Specialist

    Castellan Real Estate Partnersrajkot, India
    Remote Contracts Administrator (Only from Construction industry).We are seeking a highly organized and detail-oriented Contracts Administrator to oversee and manage subcontractor agreements, includ...Show moreLast updated: 2 hours ago
    • Promoted
    Remote - IT Purchasing Specialist

    Remote - IT Purchasing Specialist

    KPG99 INCRajkot, IN
    Remote
    Duration : Through 2025 with 1 year extension after that.Must Haves (need to be highlighted in sizzle & present on resume). Experience with Software, IT Services, software, and Hardware purchasing.St...Show moreLast updated: 4 days ago