Claims Examiner | Remote

Key Responsibilities

• Design realistic claims scenarios involving first notice of loss, coverage verification, investigation, documentation, reserving, damage evaluation, negotiation, settlement, subrogation, salvage, and closure.
• Create work products such as claim action plans, coverage analyses, investigation requests, evaluation summaries, settlement recommendations, and insured communications.
• Write 'golden' reference responses at experienced claims-professional quality.
• Grade AI-generated responses against structured rubrics for factual accuracy, policy application, claim-handling judgment, and procedural completeness.
• Identify premature conclusions, missing investigative steps, unsupported valuations, improper communications, and failures to distinguish covered damage from excluded or unrelated loss.
• Provide written feedback the research team uses to improve model behavior.
• Participate in onboarding office hours and calibration sessions.

Core Requirements

• Have strong relevant experience in P&C claims handling, adjusting, or examining.
• Have independently handled claims in at least one area, such as property, auto physical damage, bodily injury, general liability, commercial casualty, catastrophe, or specialty claims.
• Understand the claim lifecycle from intake and investigation through evaluation, resolution, recovery, and closure.
• Can read and apply policy language to claim facts while recognizing when escalation is required.
• Demonstrate excellent written analysis, balanced judgment, and high attention to detail.
• Can distinguish ordinary claim adjudication from complex coverage, litigation, regulatory, and actuarial work.