Claims Operations Specialist

Key Responsibilities

• Translate real-world Insurance workflows into structured tasks for AI systems
• Evaluate AI-generated outputs for accuracy, logical reasoning, and domain correctness
• Work on use cases including claims review, underwriting analysis, policy administration, and risk evaluation
• Analyze claims data, policy documents, and risk reports to identify trends, risks, and opportunities
• Clearly document assumptions, thought processes, and decisions
• Provide feedback to improve AI performance and outputs

Required Qualifications

• Strong experience in Insurance Operations, Claims Management, Underwriting, or Risk
• Proven experience in claims adjudication, underwriting, policy administration, subrogation, risk analysis (at least three of these)
• 5-10 years of relevant experience (flexible for strong candidates)
• Strong analytical and problem-solving skills
• Excellent attention to detail and communication skills