Claims Operations Expert

As a Claims Operations Expert, you will play a crucial role in advancing frontier agent evaluations in claims operations. Your primary responsibility will be to create long-horizon claims tasks that reflect real-world scenarios, each accompanied by a deterministic rubric to evaluate agent performance against verifiable ground truth. The tasks you design will require checkable answers, avoiding open-ended questions or subjective judgments.

• FNOL and Triage: Develop tasks for intake using required-field checklists, conduct coverage analysis with documented correct determinations, and assign claims based on defined routing rules.
• Adjudication: Create scenarios for reserve setting according to guidelines with ground-truth reserve amounts, ensure adjuster notes include required elements, and draft settlement or denial letters aligned with policy language.
• Specialized Handling: Design tasks for subrogation screening based on defined criteria, trigger SIU fraud referrals using rule-based red flags, and manage litigation files against required-document lists.

These scenarios will be intellectually challenging and require extended periods of focused attention.

• Minimum of 3 years of experience as a claims adjuster, claims operations specialist, or claims supervisor in property & casualty, workers compensation, or specialty lines.
• Adjuster licensure in at least one US state is strongly preferred.
• Expertise in one or more areas including specific claim types (auto, property, general liability, workers compensation, medical), coverage analysis and policy interpretation, reserving practices, subrogation, SIU or fraud investigation, or familiarity with claims systems (Guidewire ClaimCenter, Duck Creek, or legacy carrier systems).
• Ability to read and produce claims artifacts such as FNOLs, coverage opinions, reserve memos, adjuster notes, and settlement and denial letters.
• Strong written communication skills, with the ability to articulate reasoning clearly and encode it into deterministic rubrics.
• Must be located in the United States.

This is a remote position with an hourly employment type.

The hourly rate ranges from $55 to $80, depending on domain expertise and prior experience. Strong contributors will have opportunities for promotion based on the quality and throughput of their tasks.

Applicants must be located in the United States.