Clinical Claims SME & Coach (USRN) – On-site

Aitomic Jobs; Taguig; Hybrid; PHP 900,000 - 1,500,000; Full time

Job summary

Sutherland is seeking a licensed US Registered Nurse (USRN) to join as a Subject Matter Expert for the AO Clinical Claims Program in Taguig. This on-site role blends clinical review with claims analysis, coaching, and process governance to ensure accuracy, quality, and compliance in disability management workflows.

The SME will balance production workload with real-time SME support, collaborate with operations leaders, quality teams, trainers, and client stakeholders, and model best practices in

Qualifications

• Licensed US Registered Nurse with experience in clinical claims.
• Strong analytical skills and attention to detail.
• Ability to collaborate with operations leaders, quality teams, trainers, and client stakeholders.
• Experience coaching or mentoring production teams is a plus.

Responsibilities

• Serve as the primary clinical SME for disability and clinical claims operations.
• Review complex cases and provide recommendations to associates and leadership.
• Support floor coaching, training, and real-time assistance to agents and analysts.
• Maintain a personal caseload while meeting productivity and quality targets.

Skills

USRN

Clinical claims

Analytical skills

Team collaboration

Coaching

Job description

Sutherland is seeking a licensed US Registered Nurse (USRN) to join as a Subject Matter Expert for the AO Clinical Claims Program in Taguig. This on-site role blends clinical review with claims analysis, coaching, and process governance to ensure accuracy, quality, and compliance in disability management workflows.

The SME will balance production workload with real-time SME support, collaborate with operations leaders, quality teams, trainers, and client stakeholders, and model best practices in