Insurance Claims Analyst

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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