Complex Claims and Coverage Director

Job not on LinkedIn

🔥 1 minute ago

🌐 United States, Australia, +4 more countries – Remote

🇺🇸 United States – Remote 🇦🇺 Australia – Remote 🇨🇦 Canada – Remote 🇳🇿 New Zealand – Remote 🇬🇧 United Kingdom – Remote 🇩🇪 Germany – Remote

💵 $80 / hour

⏳ Contract/Temporary

🔴 Lead

👔 Director

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Weekday (YC W21)

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2021

💼 Consulting

👥 HR Tech

☁️ SaaS

Consulting • HR Tech • SaaS

Weekday is a modern recruitment platform that combines AI technologies with a vast database of potential candidates, aiming to streamline the hiring process for companies in India. They offer various services, including a proactive outreach approach that helps employers connect with top talent, as well as tools for candidates to easily apply for jobs. Weekday's emphasis on candidate engagement through multiple channels, including email, WhatsApp, and phone calls, sets it apart in the competitive landscape of recruitment agencies.

📋 Description

• 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 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 to improve model behavior • Participate in onboarding office hours and calibration sessions • Train frontier AI models using high-quality insurance reasoning data

🎯 Requirements

• 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims • Experience evaluating coverage issues and developing claim strategies involving multiple parties, layers, policies, or jurisdictions • Understanding of insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel • Ability to distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required • Exceptional written reasoning, defensible judgment, and high attention to detail • Comfortable reviewing incomplete records and clearly separating facts, assumptions, open issues, and recommended next steps • CPCU, AIC, SCLA, ARM, or comparable insurance designation is a bonus qualification • Experience with excess casualty, professional liability, directors and officers, cyber, environmental, construction-defect, or other complex lines is a bonus qualification • Experience managing mediations, trials, coverage disputes, or extra-contractual exposure is a bonus qualification • Home-office technical claims or claim-governance experience is a bonus qualification • Experience overseeing TPAs, independent adjusters, experts, or panel counsel is a bonus qualification • Law degree or license to practice law is not required

🏖️ Benefits

• Minimum 20 hours per week (ideally 40+) • Role starts immediately • Reasonable accommodations upon request