Social Insurance Specialist

OpenTrain AI, Inc.; États-Unis; À distance; USD 83 000 - 117 000; Temps partiel

Résumé du poste

OpenTrain AI, Inc. seeks a remote Social Insurance Specialist (Claims Review) to join as a part-time contractor in the United States. You will review AI-generated social insurance claims, verify evidence, assess eligibility, and confirm benefit calculations in line with program rules.

You’ll document clear rationales for decisions and contribute to model improvement. Daily work involves using claims systems and providing written feedback to improve AI accuracy, with compensation in the remote

Qualifications

• Knowledge of eligibility decisions, benefit entitlement, evidence gathering, and regulated program rules.
• Experience with claims processing or case management systems such as SSA tools.
• Ability to synthesize complex records and explain decisions clearly for higher‑level review.

Responsabilités

• Review AI-generated social insurance claims and benefit decisions for accuracy.
• Assess evidence, eligibility, entitlement, and benefit computations.
• Complete or verify determinations and document rationales.
• Perform QA against agency policies and standards, including POMS.
• Access and manage case files in claims systems and respond to reconsiderations.

Connaissances

Claims processing

Evidence gathering

Policy compliance

Eligibility decisions

Written communication

Outils

SSA MCS

MSSICS

Description du poste

Social Insurance Specialist (Claims Review)

Review AI-generated social insurance claims and benefit decisions, checking evidence, eligibility, calculations, and policy compliance. This remote U.S. contract role pays $60 to $85 per hour and uses your claims expertise to improve AI systems.

Remote Hourly · $60–$85/hr

$60–$85/hr

Compensation

Contract, part‑time

Engagement

Remote

Location

Posted

Open to applicants in

United States

The work

You will review AI-generated claims and benefit decisions for social insurance programs. Your work will help assess whether proposed outcomes are supported by evidence, accurate under program rules, and clearly explained for AI training.

• Review retirement, survivors, disability, and supplemental income claims.
• Assess evidence, eligibility, entitlement, and benefit computations.
• Complete or verify benefit determinations and document clear rationales.
• Perform quality reviews against agency policies and standards, including POMS.
• Use claims and records systems to access, update, and manage case files.
• Review reconsiderations, appeals, overpayments, and underpayments.
• Give written and verbal feedback to improve model accuracy.

What it pays and takes

This is a remote, part‑time contractor role open to candidates in the United States.

• Pay: $60 to $85 per hour.
• Location: Remote and open to candidates in the United States.
• Knowledge of eligibility decisions, benefit entitlement, evidence gathering, and regulated program rules.
• Familiarity with GS-0105 Social Insurance Administration functions or related classifications such as GS-0996 or GS-0512.
• Experience with claims processing or case management systems, including SSA MCS, MSSICS, or similar tools.
• Experience with claims quality assurance in a federal, state, or related agency setting.
• Ability to synthesize complex records and explain well‑supported decisions for higher‑level review.
• Experience administering social insurance or benefit programs, making eligibility determinations, calculating benefits, or serving the public is helpful.

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