Subject Matter Expert (SME) - Clinical Claims Operations

📋 Description

• Serve as the primary clinical subject matter expert for disability and clinical claims operations.
• Interpret and apply client-specific guidelines, medical policies, and standard operating procedures.
• Review complex cases and provide recommendations to associates and leadership teams.
• Provide floor support and real-time assistance to agents and analysts.
• Conduct case reviews, side-by-side coaching, and knowledge-sharing sessions.
• Facilitate refresher sessions and uptraining programs.

🎯 Requirements

• Active and unrestricted US Registered Nurse (USRN) license.
• Bachelor's Degree in Nursing (BSN).
• Minimum 2-3 years of US healthcare experience in disability claims, clinical claims review, or
• At least 1 year experience in a Subject Matter Expert, Senior Clinical Reviewer, Team Lead, or
• Knowledge of medical terminology, disease processes, and treatment protocols.
• Proficiency in Microsoft Office applications (Excel, Word, PowerPoint, Outlook).

🎁 Benefits

• Full-time permanent employment.