Jobs

Interviews
Job Alerts
Tools

Upskill and Grow with AI

Mock Interview Practice interviews in realistic simulations

Coding Practice Improve your coding skills with challenges

Certification Earn certifications to validate your skills

AI Learning Get trained with AI expert sessions

Career Path AI insights for smarter career decisions

AI Job Match Score AI-Powered Job Match Against Your Resume and Optimize Your Resume

Career Tools and Resources

Resume Builder Build Professional Resume with Ease

ATS Friendliness Check Check Resume Friendliness for Applicant Tracking Systems

Auto Apply Apply to hundreds of jobs on any platform effortlessly

Co-Pilot (Chrome Extension) Your AI Assistant for Seamless Browsing Efficiency

Interview Questions Streamline interviews with ready-to-use questions

Salaries Discover market-driven salary insights across skillsets and geographies

Companies Explore leading companies actively hiring talent
For Employers

Jobs

Interviews

Home
>
Jobs in indore
>
Sagality India
>
Subject Matter Expert For claims in US Healthcare

Subject Matter Expert For claims in US Healthcare

Sagality India

3 - 8 years

4 - 5 Lacs

indore coimbatore bengaluru

Posted:1 week ago| Platform:

Apply

Skills Required

claims us healthcare claims adjudication health claims claims management insurance claims subject matter expertise sme us insurance subject matter expert claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Urgent Hiring Subject Matter Expert (SME) Operations Claims Adjudication (US Healthcare)

Location:

Role Summary:

Subject Matter Expert (SME) Operations

Key Responsibilities:

Serve as the
go-to expert
for operations in claims adjudication processes, policies, and client requirements.
Provide
on-floor support
to resolve complex claim adjudication cases and escalations.
Conduct
knowledge-sharing sessions, refreshers, and process updates
for the operations team.
Collaborate with training teams to build
effective learning modules
for new hires and existing staff.
Support operations leaders in meeting
SLAs, accuracy, and productivity targets
.
Partner with quality teams to ensure
error-free processing and compliance adherence
.
Assist in
client calls, process transitions, and audits
by offering subject matter expertise.
Create, update, and maintain
SOPs, job aids, and process documentation
.
Identify opportunities for
process improvement and efficiency enhancement
within operations.

Core Skills & Competencies:

Minimum
3.6 years of experience
in
US healthcare claims adjudication operations
.
Strong expertise in
claims processing
(Medical, Dental, Hospital & Pharmacy claims).
Proven ability to
resolve complex claims and escalations
in operations.
Strong
analytical, problem-solving, and decision-making
skills.
Effective
communication, mentoring, and stakeholder management
.

Contact Persons:

Coimbatore:

More Jobs at Sagality India

Team Leader

Bengaluru

5 - 7 yrs

INR 4 - 6 Lacs

Talent Acquisition Manager

Bengaluru

8 - 11 yrs

INR 7 - 11 Lacs

Hiring Experienced AR Callers @Hyderabad

Hyderabad

1 - 4 yrs

INR 1 - 4 Lacs

Urgent Hiring For International Voice Process

Hyderabad

Experience: Not specified

INR 2 - 3 Lacs

International Voice Customer Support Executive

Bengaluru

Experience: Not specified

INR 3 - 5 Lacs

Mock Interview

Practice Video Interview with JobPe AI

Start Job-Specific Interview

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.