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

Claims Clerk

Scry AIludhiana, punjab, in
5 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 • ludhiana, punjab, in

    Related jobs
    • Promoted
    Accounts Receivable Specialist

    Accounts Receivable Specialist

    SourceIN Solutionsludhiana, punjab, 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: 5 days ago
    • Promoted
    • New!
    Fraud Operations Associate (L1) – E-commerce / Payment Risk (2 to 5 years)

    Fraud Operations Associate (L1) – E-commerce / Payment Risk (2 to 5 years)

    AIMLEAPludhiana, punjab, in
    AIMLEAP is a global technology consulting powerhouse, specializing in end-to-end full-stack development of AI-powered solutions with a focus on performance, scalability, and security.Certified with...Show moreLast updated: 21 hours ago
    • Promoted
    Loan Processor (Australia)

    Loan Processor (Australia)

    Global Assistludhiana, punjab, 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
    Trade operations - Bill Booking and LC Handling

    Trade operations - Bill Booking and LC Handling

    Mizuholudhiana, punjab, 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: 5 days ago
    • Promoted
    Collections Analyst

    Collections Analyst

    Branch Internationalludhiana, punjab, 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
    Administrative Assistant

    Administrative Assistant

    Sandeep AssiJalandhar, Punjab, India
    An accounting firm working for transportation and IT companies.This is a remote contract role for an Administrative Assistant at Elk Prime Financial. The Administrative Assistant will be responsible...Show moreLast updated: 2 days ago
    • Promoted
    Duck Creek Claims Developer (V10 or V11)

    Duck Creek Claims Developer (V10 or V11)

    Next Venturesludhiana, punjab, 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: 14 days ago
    • Promoted
    Go High Level (GHL) Specialist

    Go High Level (GHL) Specialist

    Aonxiludhiana, punjab, in
    Go High Level (GHL) Specialist.PM IST – 4 : 30 AM IST (US Working Hours).We are KPI-positive in 60 days and trusted by over 500 U. Our approach includes AI-enabled Revenue Pods with Lead Generators, Q...Show moreLast updated: 3 days ago
    • Promoted
    Specialist - Privacy Implementation

    Specialist - Privacy Implementation

    Baldor Technologies Private Limited (IDfy)ludhiana, punjab, 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: 30+ days ago
    • Promoted
    Junior Accountant

    Junior Accountant

    Shrey SportsJalandhar, Punjab, India
    Shrey is a leading name in cricket helmets and sports apparel, trusted by elite athletes worldwide.We began our journey crafting top-tier cricket helmets and quickly earned our place on internation...Show moreLast updated: 5 days ago
    • Promoted
    US Healthcare Recruiter

    US Healthcare Recruiter

    Hirring.comludhiana, punjab, in
    US healthcare space with a commission-based payment structure.This is a Part-Time position, work remotely at any time and from anywhere. Experience with full recruitment cycles across the healthcare...Show moreLast updated: 5 days ago
    • Promoted
    Purchasing Assistant

    Purchasing Assistant

    Bhagwansons Centerless GrindersLudhiana, Punjab, India
    Bhagwansons, a trusted partner in world-class centerless grinding solutions since 1964, has been at the forefront of the grinding industry for over six decades. We deliver high-precision machines an...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Remote - IT Purchasing Specialist

    Remote - IT Purchasing Specialist

    KPG99 INCludhiana, punjab, 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: 21 hours ago
    • Promoted
    • New!
    Purchase Specialist

    Purchase Specialist

    KPG99 INCludhiana, punjab, in
    Must Haves (need to be highlighted in sizzle & present on resume).Experience with Software, IT Services, software, and Hardware purchasing. Strong experience negotiating with vendors.Experience work...Show moreLast updated: 21 hours ago
    • Promoted
    Insurance Specialist

    Insurance Specialist

    Scry AIludhiana, punjab, 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: 8 days ago
    • Promoted
    AS400 Developer – Healthcare & Claims Processing

    AS400 Developer – Healthcare & Claims Processing

    Onesmarter Includhiana, punjab, in
    Job Title : AS400 Developer – Healthcare & Claims Processing.Develop, maintain, and optimize AS400-based applications for healthcare claims processing. Ensure seamless integration of claims data with...Show moreLast updated: 3 days ago
    • Promoted
    BA / QA (-Life Insurance / Annuity )

    BA / QA (-Life Insurance / Annuity )

    Skillveraludhiana, punjab, 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: 5 days ago
    • Promoted
    Guidewire Billing Developer

    Guidewire Billing Developer

    The AES Groupludhiana, punjab, 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: 15 days ago