Disability Claims & Underwriting Specialist — AI Reasoning

Dorado; United States; Remote; USD 60,000 - 120,000; Full time

Job summary

Mercor partners with a leading AI lab to design disability adjudication and risk-selection scenarios, evaluate model outputs, and shape how AI reasons about disability definitions, medical evidence, and entitlement.

The role welcomes professionals in disability claims adjudication, underwriting, vocational rehabilitation, return-to-work, and related areas from carriers, TPAs, and employer programs. Remote or flexible engagement may be available.

Qualifications

• 2+ years of professional experience in disability claims adjudication, disability underwriting, vocational rehabilitation, or leave and absence management.
• Have worked 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.
• Understand how contract definitions, elimination periods, offsets, pre-existing-condition provisions and maximum benefit periods determine entitlement and duration.
• Can weigh medical, occupational and financial evidence and articulate a defensible determination with a documented rationale.
• Demonstrate excellent written analysis, balanced judgment and high attention to detail.
• Can distinguish claim adjudication from treating-provider clinical decisions and from formal legal advice.

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
• Participate in onboarding office hours and calibration sessions

Skills

Disability claims adjudication

Disability underwriting

Vocational rehabilitation

Leave and absence management

Written analysis

Attention to detail

Analytical writing

Education

CRC

CDMS

CCM

CPDM

RN

Job description

Mercor partners with a leading AI lab to design disability adjudication and risk-selection scenarios, evaluate model outputs, and shape how AI reasons about disability definitions, medical evidence, and entitlement.

The role welcomes professionals in disability claims adjudication, underwriting, vocational rehabilitation, return-to-work, and related areas from carriers, TPAs, and employer programs. Remote or flexible engagement may be available.