Talent.com
Claims Clerk

Claims Clerk

Scry AImumbai city, India
9 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 • mumbai city, India

    Related jobs
    • Promoted
    Cluster Manager - Marine Claims (High Salary)

    Cluster Manager - Marine Claims (High Salary)

    Edme Insurance BrokersMumbai, Maharashtra, India
    Team Management & Operations - Supervise and guide a team of claims executives handling commercial lines claims.Allocate workloads, set priorities, and ensure adherence to service level timelines....Show moreLast updated: 6 days ago
    • Promoted
    • New!
    Claims Analyst [Urgent]

    Claims Analyst [Urgent]

    GeoServeMumbai, Maharashtra, India
    Join Our Team as a Claims Analyst | Mumbai.As Claims (Demurrage) Analyst, you will be responsible for Demurrage & Post-fixture claims. Manage demurrage & post-fixture claims.Liaise with the client t...Show moreLast updated: 3 hours ago
    • Promoted
    Tax Specialist

    Tax Specialist

    Saint-GobainThane, IN
    Perform monthly reconciliations between books of accounts and GST returns (GSTR-3B).Identify and resolve discrepancies in Input Tax Credit (ITC) claims and tax liabilities.GST General Ledger (GL) K...Show moreLast updated: 26 days ago
    • Promoted
    Specialist - Privacy Implementation

    Specialist - Privacy Implementation

    Baldor Technologies Private Limited (IDfy)Thane, 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: 16 days ago
    • Promoted
    Complaints Handler - Home finance

    Complaints Handler - Home finance

    Talent Corner HR Services Pvt LtdMumbai, Maharashtra, India
    The ORM Executive will serve as a key guardian of brand reputation for a home finance client, ensuring trust and credibility among customers. The role involves monitoring online conversations, manag...Show moreLast updated: 13 days ago
    • Promoted
    Audit Manager- Healthcare

    Audit Manager- Healthcare

    Citrin Cooperman India LLPKalyan-Dombivli, IN
    Job Title : A&A Manager (Assisted Living / Nursing Home / Healthcare).Citrin Cooperman is one of the largest accounting and consulting firms in the United States, and 4th among mid-Atlantic firms, with ...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    3 Days Left : Claims Specialist

    3 Days Left : Claims Specialist

    GrayQuestMumbai, Maharashtra, India
    GrayQuest is India’s leading FinTech innovator in the education ecosystem, transforming the.B+ education industry through its cutting-edge financial solutions. EMI solutions for school and college f...Show moreLast updated: 3 hours ago
    • Promoted
    • New!
    [Apply in 3 Minutes] Compliance Billing

    [Apply in 3 Minutes] Compliance Billing

    Newfold DigitalMumbai, Maharashtra, India
    Newfold Digital is a leading web technology company serving millions of customers globally.We have some of the industry's most. We help customers of all sizes build a digital presence that.With our ...Show moreLast updated: 3 hours ago
    • Promoted
    Duck Creek Billing Architect or Technical SME

    Duck Creek Billing Architect or Technical SME

    HTC Global ServicesKalyan-Dombivli, IN
    Connects- We are seeking an experienced.Duck Creek Billing solution in a P&C insurance environment.You will provide technical leadership, oversee solution architecture, work closely with business a...Show moreLast updated: 6 days ago
    • Promoted
    Invoicing & Billing Specialist

    Invoicing & Billing Specialist

    ZafifyKalyan-Dombivli, IN
    GCC (UAE Experience / knowledge is an added advantage).We are looking for an Invoicing Specialist to join our external team. The ideal candidate should have strong experience in billing and invoicing ...Show moreLast updated: 8 days ago
    • Promoted
    Head - Insurance - Claims

    Head - Insurance - Claims

    Talent Toppers LLPMumbai, India
    Role : Head - Insurance Experience Required : 17-20 years Key Responsibilities : - Insurance Expertise : In-d...Show moreLast updated: 2 days ago
    • Promoted
    OpenLink Endur Findur QA (Consultant / Senior / Principal Consultant)

    OpenLink Endur Findur QA (Consultant / Senior / Principal Consultant)

    KWA AnalyticsKalyan-Dombivli, IN
    About KWA Analytics : We are a global organisation offering a comprehensive range of consulting services for trade lifecycle management to clients involved in energy, commodities, shipping, treasury...Show moreLast updated: 30+ days ago
    • Promoted
    Cluster Manager - Marine Claims

    Cluster Manager - Marine Claims

    Edme Insurance BrokersMumbai, Maharashtra, India
    Supervise and guide a team of claims executives handling commercial lines claims.Allocate workloads, set priorities, and ensure adherence to service level timelines. Review claim files for accuracy,...Show moreLast updated: 16 days ago
    • Promoted
    Compliance Billing

    Compliance Billing

    Newfold DigitalMumbai, Maharashtra, India
    Newfold Digital is a leading web technology company serving millions of customers globally.We have some of the industry's most. We help customers of all sizes build a digital presence that.With our ...Show moreLast updated: 16 days ago
    • Promoted
    Claims Investigations Manager

    Claims Investigations Manager

    SKD HEALTH ALLIED SERVICESMumbai, Maharashtra, India
    SKD Health Allied Services is a reputed organization and a pioneer in the industry of claims investigations across south India and Maharashtra, having its offices at Chennai , Bangalore , Ernakulam...Show moreLast updated: 5 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    GrayQuestMumbai, Maharashtra, India
    GrayQuest is India’s leading FinTech innovator in the education ecosystem, transforming the.B+ education industry through its cutting-edge financial solutions. EMI solutions for school and college f...Show moreLast updated: 19 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    HowdenMumbai, Maharashtra, India
    Industry : General Insurance / Insurance Broking / Insurance Surveyor.Reporting To : Business Head / Vertical Head.The role holder will lead the claims function across all Specialty lines of business, ...Show moreLast updated: 16 days ago
    • Promoted
    Claims Analyst

    Claims Analyst

    GeoServeMumbai, Maharashtra, India
    Join Our Team as a Claims Analyst | Mumbai.As Claims (Demurrage) Analyst, you will be responsible for Demurrage & Post-fixture claims. Manage demurrage & post-fixture claims.Liaise with the client t...Show moreLast updated: 30+ days ago