Senior Complex Claims & Coverage Director

Weekday; United States; Teletrabalho; USD 83 000 - 166 000; Tempo parcial

Vantagens oferecidas por esta oferta de emprego

$80/hour

Flexible part-time hours

Immediate start

Accommodations on request

Resumo da oferta

RemoteLeads seeks a part-time insurance claims strategist to design and evaluate complex, high-severity scenarios and settlements. You will develop multi-party strategies, assess coverage issues across jurisdictions, and escalate to counsel when needed.

Strong written reasoning and detail orientation are essential as you help train models and improve claim processes. You will also grade AI responses against policy standards, identify gaps, and contribute to onboarding and calibration sessions.

Qualificações

• 2+ years handling complex, litigated, high-severity or coverage-sensitive claims.
• Experience evaluating coverage issues across multiple parties, layers, policies, or jurisdictions.
• Knowledge of insurer duties, reservation-of-rights practices, litigation management, and escalation to counsel.
• Ability to distinguish operational coverage positions from legal advice and identify when legal review is needed.
• Exceptional written reasoning and defensible judgment.
• Ability to review incomplete records and separate facts, assumptions, and next steps.

Responsabilidades

• Design realistic dispute scenarios involving coverage, rights reservation, excessive exposure, multiple insureds and carriers, and settlements.
• Create complex claim strategies, coverage-position analyses, authority requests, and litigation-management plans.
• Write senior-level reference responses for model training.
• Grade AI-generated responses using policy, strategy, and escalation rubrics.
• Identify inconsistent or unsupported claim-handling positions.
• Provide written feedback to improve model behavior and participate in onboarding/calibration sessions.

Conhecimentos

Complex claims handling

Litigation awareness

Coverage evaluation

Attention to detail

Written reasoning

Formação académica

CPCU or similar

Descrição da oferta de emprego

RemoteLeads seeks a part-time insurance claims strategist to design and evaluate complex, high-severity scenarios and settlements. You will develop multi-party strategies, assess coverage issues across jurisdictions, and escalate to counsel when needed.

Strong written reasoning and detail orientation are essential as you help train models and improve claim processes. You will also grade AI responses against policy standards, identify gaps, and contribute to onboarding and calibration sessions.