Disability Claims Adjudication Specialist

Mercor; Sydney; Remote; AUD 137,000 - 176,000; Part time

Job summary

Mercor is seeking a Disability Claims & Underwriting Specialist to join as a remote, hourly contractor. The role involves designing disability scenarios, producing determinations, and improving model outputs with expert feedback.

Required experience includes disability adjudication or underwriting, with knowledge of program types and benefit calculations. This remote position offers flexible hours (20–40 hours per week) and weekly payments via Stripe Connect.

Qualifications

• 2+ years of professional experience in disability claims adjudication, underwriting, rehab, or leave management.
• Experience with at least one program type (short-term/long-term disability, income, life waiver).
• Understanding of elimination periods, offsets, pre-existing conditions and max benefit periods.
• Ability to weigh medical, occupational and financial evidence with a documented rationale.
• Excellent written analysis, balanced judgment and attention to detail.

Responsibilities

• Design scenarios for short- and long-term disability claims and related definitions.
• Create claim determinations, benefit calculations, and medical/vocational summaries.
• Write high-quality, reference-grade responses for disability topics.
• Grade AI outputs against rubrics for accuracy and fairness.
• Identify misapplied definitions, incorrect math, or missing records.
• Provide written feedback to improve model behavior.

Skills

Disability claims adjudication

Disability underwriting

Vocational rehabilitation

Leave and absence management

Analytical writing

Education

CRC

CDMS

CCM

CPDM

RN

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position Details

Position: Disability Claims & Underwriting Specialist

Type: Contract

Compensation: $80/hour

Location: Remote

Commitment: 20–40 hours/week

Role Responsibilities

• Design realistic scenarios involving short- and long-term disability claims, elimination periods, own-occupation and any-occupation definitions, residual and partial disability, offsets, recurrent disability, and claim duration management.
• Create work products such as claim determinations, benefit calculations, medical and vocational evidence summaries, transferable-skills analyses, return-to-work plans, and appeal decisions.
• Write "golden" reference responses at experienced disability-professional quality.
• Grade AI-generated responses against structured rubrics for definitional accuracy, evidentiary support, benefit-calculation correctness, and procedural fairness.
• Identify misapplied disability definitions, unsupported functional conclusions, missed offsets, incorrect benefit math, and failures to document the administrative record.
• Provide written feedback the research team uses to improve model behavior.

Qualifications

Must-Have

• 2+ years of professional experience in disability claims adjudication, disability underwriting, vocational rehabilitation, or leave and absence management.
• Experience with at least one program type, such as group short-term disability, group long-term disability, individual disability income, statutory disability, or life waiver of premium.
• Understanding of contract definitions, elimination periods, offsets, pre-existing-condition provisions, and maximum benefit periods.
• Ability to weigh medical, occupational, and financial evidence and articulate a defensible determination with a documented rationale.
• Excellent written analysis, balanced judgment, and high attention to detail.
• Ability to distinguish claim adjudication from treating-provider clinical decisions and from formal legal advice.

Preferred

• CRC, CDMS, CCM, CPDM, RN, or comparable clinical or vocational credential.
• Experience with ERISA administrative records, appeals, or litigation support.
• Individual disability income underwriting, including occupation class and financial underwriting.
• Social Security, workers compensation, or other-income offset coordination experience.
• Experience with FMLA, state leave programs, or ADA accommodation interaction.

Start Date

• Immediately; applications reviewed on a rolling basis.

Compensation & Legal

• Hourly contractor, Paid weekly via Stripe Connect.