Product SME - Workers Compensation
$120,000–$140,000 year
RemoteUnited States
Job Summary
Map the Workers' Compensation claim lifecycle from FNOL through closure to identify friction points, gaps in injury and wage data, and opportunities for automation that reduce duration and leakage. Define practical standards for investigation, compensability, medical management, reserves, and return-to-work planning to improve decision quality and reserve accuracy. Translate deep claims judgment into product requirements, workflows, and decision frameworks that align Product, Engineering, Analytics, and Claims Operations around a unified definition of quality. Communicate complex claims concepts and tradeoffs clearly across technical and non-technical audiences to drive measurable improvements in claim outcomes.
Required Qualifications
- Deep, hands-on Workers' Compensation claims experience, ideally as a field or desk adjuster, examiner, supervisor, or claims leader at a P&C carrier, TPA, or Workers' Compensation focused organization
- Strong knowledge of the full claim lifecycle: FNOL, investigation, compensability, medical management, indemnity, wage calculation, reserving, return to work, settlement, and closure
- Familiarity with jurisdictional complexity and the judgment to balance consistency, compliance, claimant outcomes, and business performance
- A demonstrated ability to evaluate complex workflows, identify root causes, and distinguish meaningful improvements from cosmetic ones
- Comfort owning ambiguous, high-leverage work with significant operational and financial impact
- Curiosity about how automation and AI can improve claims workflows—paired with the judgment to know where human expertise, documentation, and controls still matter
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