Senior Complex Claims & Coverage Director

Dorado; United States; Remote; USD 120,000 - 160,000; Full time

Job summary

Dorado is partnering with a leading AI lab to train frontier models on insurance reasoning data. We’re hiring Complex Claims and Coverage Directors to design high-severity claim scenarios and evaluate model outputs against senior standards.

Senior carrier claims professionals and coverage specialists are welcome. This is an insurance-practitioner role not requiring a law degree or license.

Qualifications

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

Responsibilities

• Design realistic scenarios involving disputed coverage and high-severity settlement strategy.
• Create work products such as complex claim strategies, coverage-position analyses, authority requests, and litigation-management plans.
• Write gold-standard reference responses at senior technical claims quality.
• Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, and escalation discipline.
• Identify positions that are internally inconsistent or outside authority of a non-lawyer claims professional.
• Provide written feedback to the research team to improve model behavior.
• Participate in onboarding office hours and calibration sessions.

Skills

Complex claims

Coverage analysis

Litigation management

Written reasoning

Attention to detail

Stakeholder communication

Education

CPCU/AIC/SCLA/ARM or comparable designation

Tools

Legal and claims governance

Job description

Dorado is partnering with a leading AI lab to train frontier models on insurance reasoning data. We’re hiring Complex Claims and Coverage Directors to design high-severity claim scenarios and evaluate model outputs against senior standards.

Senior carrier claims professionals and coverage specialists are welcome. This is an insurance-practitioner role not requiring a law degree or license.