Leads the business systems team and architecture behind quote-to-cash, go-to-market, and finance operations, aligning Salesforce, billing, ERP, and data flows to support scalable growth.
Complex Claims & Coverage Director
π Description
- Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple parties and policies, litigation, mediation, and high-severity settlements.
- Create claim strategies, coverage analyses, authority requests, litigation plans, reserve rationales, and escalation recommendations.
- Write senior-quality reference responses and grade AI outputs against structured rubrics.
- Identify inconsistent, unsupported, or operationally unrealistic claim positions and flag matters requiring legal review.
- Provide written feedback and participate in onboarding office hours and calibration sessions.
π οΈ Requirements
- Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad-faith risk, and high-severity settlement strategy
- Create work products such as complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations
- Write "golden" reference responses at senior technical claims quality
- Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline
- Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional
- Provide written feedback the research team uses to improve model behavior
- Participate in onboarding office hours and calibration sessions
- Have 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims
- Have evaluated coverage issues and developed claim strategies involving multiple parties, layers, policies, or jurisdictions
- Understand insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel
β¨ Benefits
- We welcome senior carrier claims professionals, complex-claims leaders, coverage specialists, and technical claim directors. This is an insurance-practitioner role and does not require a law degree or license to practice law.
Full job description
This role is for one of our clients
Compensation: $80 per hour
We are partnering with a leading AI lab to train frontier models on high-quality insurance reasoning data. We're hiring Complex Claims and Coverage Directors to design high-severity and coverage-sensitive claim scenarios, evaluate model outputs against established senior claims standards, and help shape how the next generation of AI reasons about disputed coverage, litigation strategy, allocation, and major-loss resolution.
We welcome senior carrier claims professionals, complex-claims leaders, coverage specialists, and technical claim directors. This is an insurance-practitioner role and does not require a law degree or license to practice law.
Requirements
What You'll Do
- Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad-faith risk, and high-severity settlement strategy
- Create work products such as complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations
- Write "golden" reference responses at senior technical claims quality
- Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline
- Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional
- Provide written feedback the research team uses to improve model behavior
- Participate in onboarding office hours and calibration sessions
You're a Good Fit If You
- Have 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims
- Have evaluated coverage issues and developed claim strategies involving multiple parties, layers, policies, or jurisdictions
- Understand insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel
- Can distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required
- Demonstrate exceptional written reasoning, defensible judgment, and high attention to detail
- Are comfortable reviewing incomplete records and clearly separating facts, assumptions, open issues, and recommended next steps
Bonus Qualifications
- CPCU, AIC, SCLA, ARM, or comparable insurance designation
- Experience with excess casualty, professional liability, directors and officers, cyber, environmental, construction-defect, or other complex lines
- Experience managing mediations, trials, coverage disputes, or extra-contractual exposure
- Home-office technical claims or claim-governance experience
- Experience overseeing TPAs, independent adjusters, experts, or panel counsel
Role Highlights
- Minimum 20 hours per week (ideally 40+)
- Role starts immediately, applications reviewed on a rolling basis
We consider all qualified applicants without regard to legally protected characteristics and provide reasonable accommodations upon request.
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