Talent.com
Claims Clerk

Claims Clerk

Scry AIGreater Hyderabad Area, India
19 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 • Greater Hyderabad Area, India

    Related jobs
    • Promoted
    Guidewire Claims Developer

    Guidewire Claims Developer

    CoforgeHyderabad, Telangana, India
    Senior Engineer / Technical Lead / Senior Technical Lead.Greater Noida, Pune & Hyderabad.P&C, Property & Casualty, Claims Center, Insurance, Guidewire Claims, Java, J2EE, GOSU & Claims Integration....Show moreLast updated: 25 days ago
    • Promoted
    Purchasing Officer

    Purchasing Officer

    MNR UniversitySangareddy, Telangana, India
    Post Graduate (Any Discipline).Minimum 5 years in purchase operations for a Medical College or Hospital.The Purchase Officer (Medical) will be responsible for managing the procurement process for m...Show moreLast updated: 3 days ago
    • Promoted
    Guidewire PolicyCenter and BillingCenter / ClaimCenter

    Guidewire PolicyCenter and BillingCenter / ClaimCenter

    ConfidentialHyderabad / Secunderabad, Telangana
    Perform business analysis, gap analysis, requirement analysis, requirement gathering, functional specifications.Create documentation and develop as-is and to-be business requirements, user stories ...Show moreLast updated: 30+ days ago
    • Promoted
    Guidewire ClaimCenter

    Guidewire ClaimCenter

    ValueMomentumHyderabad, Telangana, India
    Are you a programmer who loves to design solutions to solve customer’s business problems? Do you enjoy guiding and mentoring a team of software developers? If yes, then this job is the perfect fit ...Show moreLast updated: 30+ days ago
    • Promoted
    Claims Adjuster (Property & Casualty)

    Claims Adjuster (Property & Casualty)

    ConfidentialHyderabad / Secunderabad, Telangana
    Experience Required : 4+ years (Property and Casualty domain is mandatory).Notice Period : Immediate to 30 days.Shift Timings : 6 : 30 PM to 3 : 30 AM IST (US Shifts). We are looking for an experienced Pro...Show moreLast updated: 30+ days ago
    • Promoted
    Claims Data Analyst

    Claims Data Analyst

    Corpxcel ConsultingHyderabad
    Location : Mode : Hybrid Total experience - 8+ years Relevant Experience - 5+ years Mandatory ROLE TITLE : Claims Data AnalystShow moreLast updated: 30+ days ago
    • Promoted
    Duckcreek Claims Developer

    Duckcreek Claims Developer

    ConfidentialHyderabad / Secunderabad, Telangana, Pune, Noida
    Will design & build property and casualty Insurance product using Duck Creek tool • Document technical / solution approach. Will perform Coding, Unit Testing and Code Review In Duck Creek platform •...Show moreLast updated: 30+ days ago
    • Promoted
    Delivery Manager

    Delivery Manager

    RecroGreater Hyderabad Area, India
    Proven experience with patient and / or payer data management solutions in the US pharmaceutical market.Microsoft Office suite (PowerPoint, Word). HIPAA-compliant data management experience.Experience...Show moreLast updated: 30+ days ago
    • Promoted
    Finacle Tester (GL, reconciliations module)

    Finacle Tester (GL, reconciliations module)

    ValueLabsHyderabad, Telangana, India
    Role : Finacle Tester (immediate Joiners to 30 days' Notice Only).Location – Hyderabad & Bangalore WFO.Finacle Finance GL module and integration with core modules. Must be familiar with the business ...Show moreLast updated: 12 days ago
    • Promoted
    Claims Specialist (Property & Casualty)

    Claims Specialist (Property & Casualty)

    ConfidentialHyderabad / Secunderabad, Telangana
    Experience Required 4+ years (Property and Casualty domain is mandatory).Notice Period Immediate to 30 days.Shift Timings 630 PM to 330 AM IST (US Shifts). We are looking for an experienced Property...Show moreLast updated: 30+ days ago
    • Promoted
    Guidewire Billing Tester

    Guidewire Billing Tester

    CoforgeHyderabad, Telangana, India
    Senior Test Engineer / Test Specialist / Senior Test Specialist.Greater Noida, Pune & Hyderabad.P&C, Property & Casualty, Guidewire Billing Tester, Insurance , Automation, Java, Selenium & Guidewir...Show moreLast updated: 25 days ago
    • Promoted
    Duckcreek Claims Testing

    Duckcreek Claims Testing

    ConfidentialHyderabad / Secunderabad, Telangana
    We are seeking an experienced Duck Creek Claims QA Specialist to join our dynamic team.The ideal candidate will have expertise in Duck Creek claims management systems, test case creation, and integ...Show moreLast updated: 30+ days ago
    • Promoted
    Zuora billing

    Zuora billing

    Tata Consultancy ServicesHyderabad, Telangana, India
    TCS is hiring for Zuora billing.Zuora with at least 2 end to end implementations.Hands-on experience on Zuora Workflows and APIs. Experience in having done client facing work.Excellent verbal and wr...Show moreLast updated: 15 days ago
    • Promoted
    Senior Accountant - Telecom - CA / CMA

    Senior Accountant - Telecom - CA / CMA

    SP Software (P) LimitedHyderabad, India
    Experience : 5-7 Years Location : Hyderabad Mode of Interview : F2F Mandatory Client : Telecom Product Based Company Show moreLast updated: 16 days ago
    • Promoted
    Guidewire Developer - ClaimCenter / PolicyCenter / BillingCenter Modules

    Guidewire Developer - ClaimCenter / PolicyCenter / BillingCenter Modules

    Growel Softech Pvt. Ltd.Hyderabad
    Role : Guidewire developer Description : We are seeking a skilled Guidewire Developer with 12 to 16 years of experience to join our team in India.T...Show moreLast updated: 30+ days ago
    • Promoted
    SAP Commissions (Callidus) Tester

    SAP Commissions (Callidus) Tester

    SynapOneHyderabad, Telangana, India
    Seeking a skilled Test Engineer with a strong background in SAP ECC, SAP.Commissions (Callidus) / SAP Success factor incentive management having 4-5 years. The ideal candidate will have hands-on exper...Show moreLast updated: 7 days ago
    • Promoted
    Claims Specialist (Property and Casualty)

    Claims Specialist (Property and Casualty)

    ConfidentialHyderabad / Secunderabad, Telangana
    Notice Period Immediate to 30 days.Shift Timings 630 PM to 330 AM IST (US Shifts).We are looking for an experienced Claims Specialist to support claims processing and management in the US insurance...Show moreLast updated: 30+ days ago
    • Promoted
    Guidewire Billing BA

    Guidewire Billing BA

    LTIMindtreeHyderabad, Telangana, India
    Guidewire Certification Mandatory.Candidate should have 5 to 12 years of experience in Business Analysis in Commercial and Specialty lines of Insurance domain. Experience of working on Guidewire Bil...Show moreLast updated: 15 days ago