Claims Scenario Author

Job Summary

Seeking experienced claims professionals, the part-time contract Claims Scenario Author will develop realistic scenarios for training AI agents, focusing on claims evaluation, medical evidence review, and decision-making processes.

Key responsibilities

• Develop realistic claims scenarios that require AI agents to investigate and evaluate under fictional carrier policies
• Define expected outcomes, including liability determinations and settlement recommendations
• Create fictional claim files and write evaluation criteria to ensure accuracy and consistency across scenarios

Required qualifications

• At least 3 years of hands-on experience handling bodily injury, casualty, or liability claims
• Experience reviewing medical records and identifying discrepancies in billing and clinical documentation
• Ability to interpret records from various medical specialties, including emergency care and orthopedics
• Experience valuing claims and negotiating settlements
• Excellent written English skills, with the ability to explain reasoning step by step