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

Claims Clerk

Scry AIIndia
3 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 • India

    Related jobs
    • Promoted
    Specialist - Privacy Implementation

    Specialist - Privacy Implementation

    Baldor Technologies Private Limited (IDfy)Nagpur, 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: 3 days ago
    • Promoted
    • New!
    ▷ 3 Days Left! Claims Specialist

    ▷ 3 Days Left! Claims Specialist

    GrayQuestIndia
    GrayQuest is India’s leading FinTech innovator in the education ecosystem, transforming the.B+ education industry through its cutting-edge financial solutions. EMI solutions for school and college f...Show moreLast updated: less than 1 hour ago
    • Promoted
    BA / QA (-Life Insurance / Annuity )

    BA / QA (-Life Insurance / Annuity )

    SkillveraNagpur, 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: 3 days ago
    • Promoted
    Salesforce Marketing Cloud QA Tester (India -Remote)

    Salesforce Marketing Cloud QA Tester (India -Remote)

    CloudLabs IncNagpur, IN
    Remote
    CloudLabs Inc was founded in 2014 with the mission to provide exceptional IT & Business consulting services at a competitive price, to help clients realize the best value from their investments.Wit...Show moreLast updated: 24 days ago
    • Promoted
    Cluster Manager - Marine Claims

    Cluster Manager - Marine Claims

    Edme Insurance BrokersIndia
    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: 3 days ago
    • Promoted
    Claims Clerk

    Claims Clerk

    Scry AInagpur, maharashtra, 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: 3 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    GrayQuestIndia
    About GrayQuest GrayQuest is India’s leading FinTech innovator in the education ecosystem, transforming the $100B+ education industry through its cutting-edge financial solutions.Our flagship offer...Show moreLast updated: 30+ days ago
    • Promoted
    AS400 Developer – Healthcare & Claims Processing

    AS400 Developer – Healthcare & Claims Processing

    Onesmarter IncNagpur, 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: 1 day ago
    • Promoted
    Conditional Automation UW

    Conditional Automation UW

    Renovision Automation Services Pvt. Ltd.Nagpur, IN
    Qualification : BCA / MCA / BTech / B.Candidate should have extremely good knowledge of US mortgage live underwriting process. Candidate should have experience in conditioning underwriting process.Candidat...Show moreLast updated: 3 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    HowdenIndia
    Industry : General Insurance / Insurance Broking / Insurance Surveyor Location : Mumbai Experience : 12+ years Reporting To : Business Head / Vertical Head. Role Summary The role holder will lead the clai...Show moreLast updated: 3 days ago
    • Promoted
    Guidewire Billing Developer

    Guidewire Billing Developer

    The AES GroupNagpur, 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: 13 days ago
    • Promoted
    • New!
    Claims Examiner II

    Claims Examiner II

    Smart Data SolutionsIndia
    Job Title : Claims Examiner II Do you see…? Are you passionate about …? About Us For over 20 years, Smart Data Solutions has been partnering with leading payer organizations to provide automation an...Show moreLast updated: less than 1 hour ago
    • Promoted
    Go High Level (GHL) Specialist

    Go High Level (GHL) Specialist

    AonxiNagpur, 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: 1 day ago
    • Promoted
    Trade operations - Bill Booking and LC Handling

    Trade operations - Bill Booking and LC Handling

    MizuhoNagpur, 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: 3 days ago
    • Promoted
    • New!
    (Apply in 3 Minutes) Team Leader - US healthcare

    (Apply in 3 Minutes) Team Leader - US healthcare

    Selections HR Services Private LimitedIndia
    We are seeking an experienced Team Leader to manage a team of healthcare process associates supporting our US healthcare clients. The ideal candidate will have a strong background in RCM (Revenue Cy...Show moreLast updated: less than 1 hour ago
    • Promoted
    • New!
    ▷ [Only 24h Left] Team Leader - US healthcare

    ▷ [Only 24h Left] Team Leader - US healthcare

    Selections HR Services Private LimitedIndia
    We are seeking an experienced Team Leader to manage a team of healthcare process associates supporting our US healthcare clients. The ideal candidate will have a strong background in RCM (Revenue Cy...Show moreLast updated: less than 1 hour ago
    • Promoted
    Tax Specialist

    Tax Specialist

    Saint-GobainNagpur, IN
    Perform monthly reconciliations between books of accounts and GST returns (GSTR-3B).Identify and resolve discrepancies in Input Tax Credit (ITC) claims and tax liabilities.GST General Ledger (GL) K...Show moreLast updated: 13 days ago
    • Promoted
    Assistant Claims Manager

    Assistant Claims Manager

    Visit HealthIndia
    Visit Health is a pioneering health-tech platform, founded in 2016 by BITS Pilani alumni, dedicated to making healthcare accessible, affordable, and preventive. Originated as a telemedicine platform...Show moreLast updated: 3 days ago
    • Promoted
    Duck Creek Claims Developer (V10 or V11)

    Duck Creek Claims Developer (V10 or V11)

    Next VenturesNagpur, 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: 13 days ago
    • Promoted
    • New!
    US HealthCare Recruiter (Remote Position)

    US HealthCare Recruiter (Remote Position)

    Shark Info SolutionsNagpur, IN
    Remote
    We are seeking a Healthcare Recruiter to manage full-cycle recruitment for US Healthcare professionals, focusing on Doctors, Nurses, Therapists, Technicians for US-based clients and work night shif...Show moreLast updated: 17 hours ago