Product SME – Workers Compensation

Job Description

REQUIREMENTS

• Deep, hands-on Workers’ Compensation claims experience (field or desk adjuster, examiner, supervisor, or claims leader)
• Strong knowledge of the full claim lifecycle, including investigation, medical management, and settlement
• Familiarity with jurisdictional complexity and the ability to balance compliance with business performance
• Demonstrated ability to evaluate complex workflows and identify root causes of inefficiency
• Comfort owning ambiguous, high-leverage work with significant operational and financial impact

Preferred

• Curiosity regarding how automation and AI can be applied to insurance workflows
• Experience working within a P&C carrier, TPA, or Workers’ Compensation focused organization

RESPONSIBILITIES

• Translate deep Workers’ Compensation claims expertise into product requirements, workflows, and decision frameworks
• Map the claim lifecycle from FNOL through closure to identify friction points and improvement opportunities
• Identify gaps in injury, wage, medical, and jurisdictional data needed to make sound claim decisions
• Define practical standards for investigation, documentation, compensability, and return-to-work planning
• Partner with Product, Engineering, and Analytics teams to identify where automation and AI can improve consistency and speed
• Serve as a trusted internal authority on medical management, indemnity, reserving, and jurisdictional variation

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