Subject Matter Expert (SME) – Veterans Benefits | $85/hr Remote

Crossing Hurdles; United States; Remote; GBP 61,000 - 87,000; Full time

Job summary

Crossing Hurdles is seeking a veteran services representative to review and analyze AI-generated disability compensation claims, ensuring evidence is complete and aligned with established regulatory guidelines. The role focuses on accurately weighing medical documentation and claim data to produce sound determinations.

You will document rationales for training AI models, perform quality assurance of decisions against VA standards, and use VBMS or similar systems to access and update files.

Qualifications

• Proven expertise as a Veterans Service Representative or equivalent in benefits determinations.
• Experience gathering and evaluating evidence for disability claims.
• Familiarity with federal benefit programs and regulatory guidelines.
• Experience with VA claim processes and related systems.

Responsibilities

• Review and analyze AI-generated disability claims for completeness and regulatory compliance.
• Assess AI-generated medical documentation and its effect on claims outcomes.
• Prepare detailed benefit determinations with clear rationales for AI training.
• Conduct quality assurance reviews of AI-driven decisions per VA standards.
• Access and manage claim files using VBMS or similar systems.
• Provide feedback to improve AI model accuracy for appeals and reviews.

Skills

VSR experience

VBMS experience

Evidence gathering

Regulatory compliance

QA for claims

Tools

VBMS

Job description

Type: Contract

Compensation: $60 - $85/hour

Location: Remote

Commitment: 10-40 hrs/week

Role Responsibilities

• Review and analyze AI-generated disability compensation claims, ensuring comprehensive evaluation of evidence and adherence to established regulatory guidelines.
• Assess AI-generated medical documentation and determine its impact on existing disability claims, weighing complex evidence accurately.
• Complete detailed benefit determinations and document rationales with clarity and precision for AI training.
• Conduct quality assurance reviews of AI-generated claims decisions, pinpointing inconsistencies or errors according to VA standards.
• Utilize specialized systems such as VBMS to access, update, and manage claim files and supporting documentation.
• Simulate higher‑level review decisions, providing expertise on appeals and supplemental claim processes for AI training.
• Deliver constructive written and verbal feedback to enhance AI model training accuracy and effectiveness.

Requirements

• Proven expertise as a Veterans Service Representative or equivalent, with strong experience in benefit determination and evidence gathering.
• Familiarity with GS-0996: Veterans Claims Examining, GS-0105: Social Insurance Administration, or GS-0512: Internal Revenue Agent functions.
• Demonstrated skill evaluating disability compensation and conducting claim ratings in a regulated environment.
• Experience using VBMS or similar claims management platforms.
• Background in quality assurance for claims or similar processes within federal, state, or related agencies.
• Ability to synthesize complex information and present informed decisions for higher‑level review processes.