Complex Claims Director - Insurance

Mercor; San Francisco (CA); Híbrido; GBP 729.000 - 938.000; A tiempo parcial

Descripción de la vacante

Mercor is seeking a Complex Claims & Coverage Director for a remote, contract role offering 20–40 hours per week. The start is immediate, with an AI interview-based application process.

You will design strategies for disputed coverage and provide senior-level analyses and escalation guidance. Responsibilities include creating claim strategies, performing coverage analyses, and drafting high-quality responses.

Formación

• 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims.
• Experience evaluating coverage issues and developing claim strategies involving multiple parties, layers, policies, or jurisdictions.
• Understanding of insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel.
• Ability to distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required.
• Exceptional written reasoning, defensible judgment, and high attention to detail.
• Comfort with reviewing incomplete records and clearly separating facts, assumptions, open issues, and recommended next steps.

Responsabilidades

• Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad‑faith risk, and high‑severity settlement strategy.
• Create work products such as complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations.
• Write "golden" reference responses at senior technical claims quality.
• Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline.
• Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional.
• Provide written feedback the research team uses to improve model behavior.

Conocimientos

Complex claims handling

Litigation coordination

Policy analysis

Written communication

Attention to detail

Educación

CPCU / AIC / SCLA / ARM or comparable designation

Descripción del empleo

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:

Complex Claims & Coverage Director

Type:

Contract

Compensation:

$800/hour

Location:

Remote

Commitment:

20–40 hours/week

Role Responsibilities

• Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad‑faith risk, and high‑severity settlement strategy.


• Create work products such as complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations.


• Write \"golden\" reference responses at senior technical claims quality.


• Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline.


• Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional.


• Provide written feedback the research team uses to improve model behavior.

Qualifications

Must-Have

• 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims.


• Experience evaluating coverage issues and developing claim strategies involving multiple parties, layers, policies, or jurisdictions.


• Understanding of insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel.


• Ability to distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required.


• Exceptional written reasoning, defensible judgment, and high attention to detail.


• Comfort with reviewing incomplete records and clearly separating facts, assumptions, open issues, and recommended next steps.

Preferred

• CPCU, AIC, SCLA, ARM, or comparable insurance designation.


• Experience with excess casualty, professional liability, directors and officers, cyber, environmental, construction-defect, or other complex lines.


• Experience managing mediations, trials, coverage disputes, or extra-contractual exposure.


• Home-office technical claims or claim-governance experience.


• Experience overseeing TPAs, independent adjusters, experts, or panel counsel.

Start Date

• Immediately; applications reviewed on a rolling basis.

Application Process (Takes 20–30 mins to complete)

• Upload resume


• AI interview based on your resume


• Submit form

Resources & Support

• For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome


• For any help or support, reach out to: [e-mail]

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.