Talent.com
Claims Clerk

Claims Clerk

Scry AIGhaziabad, Uttar Pradesh, 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 • Ghaziabad, Uttar Pradesh, India

    Related jobs
    • Promoted
    Claims Clerk

    Claims Clerk

    Scry AIfaridabad, haryana, in
    Claims Clerk – Subject Matter Expert (SME).TPA claims operations with SME-level proficiency.Scry AI is a research-led enterprise AI company that builds intelligent platforms to drive efficiency, in...Show moreLast updated: 23 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    HowdenDelhi, 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: 23 days ago
    • Promoted
    Claims Advocate

    Claims Advocate

    Anand Rathi Insurance Brokers LtdDelhi, Republic Of India, IN
    The Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, ma...Show moreLast updated: 2 days ago
    • Promoted
    Claims Manager - Medical Claim Audit

    Claims Manager - Medical Claim Audit

    NaviDelhi, India
    The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions.As the quality audit function, the team conducts regular audits of agent communicati...Show moreLast updated: 15 days ago
    • Promoted
    Cluster Manager - Marine Claims

    Cluster Manager - Marine Claims

    Edme Insurance BrokersDelhi, 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: 23 days ago
    • Promoted
    Senior Claims Manager - Medical Claim Audit

    Senior Claims Manager - Medical Claim Audit

    NaviDelhi, India
    About the Team The Process Excellence team at Navi is focused on maintaining and elevating the quality of customer interactions. As the quality audit function, the team conducts regular audits of ag...Show moreLast updated: 15 days ago
    • Promoted
    Specialist - Claims Assistant

    Specialist - Claims Assistant

    ConfidentialGurugram, Gurgaon / Gurugram, India
    Enters new claims into database.Checks basic claim information and settles findings appropriately.Responds to voicemail and emails and refers as necessary. Maintaining detailed records, documentatio...Show moreLast updated: 6 days ago
    • Promoted
    Medical Claims Specialist

    Medical Claims Specialist

    CorroHealthNoida, Republic Of India, IN
    Exciting news from Corrohealth! We are currently hiring for AR Callers with 1 to 4 years of experience for our US Process (Healthcare) team in Noida. This role involves working with software such as...Show moreLast updated: 23 days ago
    • Promoted
    Claims Clerk

    Claims Clerk

    ConfidentialNoida, India
    Claims Clerk – Subject Matter Expert (SME).TPA claims operations with SME-level proficiency.Scry AI is a research-led enterprise AI company that builds intelligent platforms to drive efficiency, in...Show moreLast updated: 6 days ago
    • Promoted
    Compliance and Contracts Specialist

    Compliance and Contracts Specialist

    EmeritusDelhi, IN
    The Compliance & Contract Management Services Department is looking for a Compliance and Contracts Associate to assess, analyze, draft, review, negotiate and finalize contracts, compliance, invoice...Show moreLast updated: 2 days ago
    • Promoted
    Healthcare Claims Specialist

    Healthcare Claims Specialist

    CorroHealthNoida, Republic Of India, IN
    We have huge openings for experienced AR Callers (1 - 5 Years).Please check the below job details and if you are interested and have good communication skills, please reach out to us.Should have ex...Show moreLast updated: 19 days ago
    • Promoted
    Process Associate – Insurance Claims

    Process Associate – Insurance Claims

    ConfidentialGurugram, Gurgaon / Gurugram
    Ready to shape the future of work.At Genpact, we don't just adapt to change-we drive it.AI and digital innovation are redefining industries, and we're leading the charge. Genpact's AI Gigafactory, o...Show moreLast updated: 6 days ago
    • Promoted
    Sales Force Testing

    Sales Force Testing

    Ubique SystemsDelhi, IN
    Develop QA documents such as test plans, test cases, dashboards, defect logs, test sign off, and daily reports.Conduct various testing methods depending on project needs, including but not limited ...Show moreLast updated: 2 days ago
    • Promoted
    Manager-LTL Freight Billing & Automation

    Manager-LTL Freight Billing & Automation

    ARDEM Data ServicesMeerut, IN
    Manager — LTL Freight Billing & Automation.Full-time | Strong overlap with U.Own outcomes for ARDEM’s LTL clients — from pre-sales solution design to steady-state delivery and account growth.You’ll...Show moreLast updated: 1 day ago
    • Promoted
    Claims Resolution Specialist

    Claims Resolution Specialist

    Anand Rathi Insurance Brokers LtdDelhi, Republic Of India, IN
    The Claims Function in our insurance broking company is designed to facilitate the efficient and accurate processing of insurance claims. This function aims to ensure timely resolution of claims, ma...Show moreLast updated: 2 days ago
    • Promoted
    Process Associate - Claims

    Process Associate - Claims

    ConfidentialGurugram, Gurgaon / Gurugram
    Ready to shape the future of work.At Genpact, we don't just adapt to change-we drive it.AI and digital innovation are redefining industries, and we're leading the charge. Genpact's AI Gigafactory, o...Show moreLast updated: 6 days ago
    • Promoted
    Compliance Specialist – Affordable Housing (LIHTC)

    Compliance Specialist – Affordable Housing (LIHTC)

    Castellan Real Estate PartnersDelhi, IN
    Compliance Specialist – Affordable Housing (LIHTC).Remote (Based in India, supporting California projects).Full-time | Must be available to work in Pacific Standard Time (PST) overlap hours.We are ...Show moreLast updated: 2 days ago
    • Promoted
    Pricing Specialist - (USA)

    Pricing Specialist - (USA)

    PlattonDelhi, IN
    Pricing Specialist – Ocean / Air / Drayage & Multimodal Freight (U.Our services include air and ocean freight forwarding, customs brokerage, contract logistics, warehousing and distribution, truckl...Show moreLast updated: 16 days ago