Subject Matter Expert (SME)

Role Overview The SME bridges the gap between business operations and project delivery teams. This role is responsible for defining, documenting, and communicating business processes, policies, and operational rules, with a specific focus on complex claims resolution and regulatory compliance. The ideal candidate accurately translates business unit requirements into actionable project specs, ensures strict compliance with HIPAA/PHI/ePHI standards, and provides expert guidance to project members and operational staff. Key ResponsibilitiesProcess, Policy & Business Rule Management Define & Document: Lead and support the definition of organizational processes, operational policies, business rules, and standard operating procedures (SOPs).Contextual Application: Communicate the functional contexts and operational scenarios in which specific policies, processes, and rules apply.Business Unit Representation: Act as the primary liaison representing the needs, requirements, and workflows of business units to the technical project team.Claims Guidance & Team Support Complex Claims Resolution: Provide technical expertise, tactical guidance, and operational inputs to team members on handling difficult or escalated claims.Project Guidance: Guide, mentor, and support other professionals and stakeholders across project lifecycles.Issue Resolution: Proactively identify, analyze, and resolve functional and operational issues relevant to project execution.Knowledge Sharing: Articulate and clearly explain complex subject-matter expertise to technical and non-technical stakeholders alike.Compliance, Confidentiality & Ethics Data Security & Privacy: Maintain uncompromising confidentiality of all patient and financial records, strictly adhering to PHI, ePHI, and HIPAA regulations.Organizational Compliance: Adhere strictly to company policies, procedures, and the corporate Code of Conduct.Training & Reporting: Complete all required annual compliance training modules on schedule and promptly report any observations of non-compliance through appropriate channels.Culture Alignment: Embody, review, and maintain full understanding and alignment with the organizations workplace culture statement.Core Competencies & Skills Analytical Thinking: Advanced capability in analyzing complex information and synthesising raw operational data into actionable business insights.Research & Reporting: Demonstrated skill in researching operational challenges and reporting structured results to leadership and project stakeholders.Information Confidentiality: High degree of integrity and discretion in handling sensitive medical, financial, and proprietary data.Precision & Detail: Exceptional thoroughness and strict attention to detail in process mapping, documentation, and claims evaluation.Communication & Writing: Strong internal communication skills paired with professional administrative writing ability to draft clear procedures, reports, and policies.Compensation: 30,000.00 - 60,000.00 per month Benefits: Health insuranceInternet reimbursementLeave encashmentLife insuranceProvident FundWork Location: In person .