Claims Operations Specialist
Mercor New York
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.
Position: Claims Operations ExpertType: Contract
Compensation: $55–$80/hour
Location: Remote
Role Responsibilities- Develop long-horizon claims tasks with deterministic rubrics to evaluate agent performance against verifiable ground truth.
- Build scenarios in FNOL and triage, Adjudication, and Specialized handling to ensure tasks have checkable answers.
- Evaluate FNOL and triage processes, including intake against required-field checklists and coverage analysis with documented determinations.
- Review adjudication tasks such as reserve setting against guidelines and adjuster notes with required elements.
- Collaborate on specialized handling scenarios like subrogation screening and SIU fraud referrals using rule-based criteria.
- Work independently and asynchronously to meet deadlines while improving AI model performance.
Qualifications
Must-Have- 3+ years as a claims adjuster, claims operations specialist, or claims supervisor in P&C, workers comp, or specialty lines.
- Expertise in specific claim types, coverage analysis, reserving practice, subrogation, SIU or fraud investigation, or claims systems like Guidewire ClaimCenter or Duck Creek.
- Comfortable with claims artifacts: FNOLs, coverage opinions, reserve memos, adjuster notes, settlement, and denial letters.
- Clear written communication; ability to articulate reasoning step by step and encode it into deterministic rubrics.
- Adjuster licensure in at least one US state.
- Hourly contractor
- Strong contributors promoted based on task quality and throughput.
- Upload resume
- AI interview based on your resume
- Submit form
- For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
- For any help or support, reach out to: support@mercor.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
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