Claims Clerk
Scry AIMohali, Republic Of India, IN20 days ago
Job descriptionReview submissions; Extract and validate structured fields (dates, amounts, codes); Prepare adjudication-ready files; 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; Curate ground-truth datasets and feedback loops to reduce extraction errors and false positives. Ensure documentation meets regulatory / privacy standards (IRDAI; Maintain audit trails, revision histories, and communication records. Identify fraud / abuse indicators; 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. 2+ years in claims operations (health, motor, property) at an insurer / TPA / BPO. Strong command of policy terms, EOBs; Proven record meeting TAT / accuracy targets; Proficiency with spreadsheets, PDFs, claims / CRM systems; Excellent written / verbal communication; 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). 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.
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)
verify policyholder / provider data, coverage terms, and completeness.
reconcile discrepancies.
raise RFIs and track responses to closure.
AI / Automation Enablement
validate outputs.
Compliance, Audit & Fraud Vigilance
HIPAA / GDPR as applicable).
escalate and document investigative notes.
Knowledge & Training
Required Qualifications & Skills
health lines : familiarity with CPT / ICD codes.
expert in documentationand QC.
comfort with high-volume queues.
ability to convert domain rules into clear SOPs.
Nice to Have
Our Ideal Candidate
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Clerk • Mohali, Republic Of India, IN
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