Product SME - Workers Compensation at Assured — Remote
Full job description
Workers’ Compensation claims are never just a workflow. They sit at the intersection of an injured person’s recovery, an employer’s operations, medical care, wage replacement, and a patchwork of state-specific rules. The work demands judgment: knowing what information matters, when a claim needs escalation, and how to move it forward without losing sight of the person behind it.
This role is an opportunity to bring that judgment into technology. As a Product Subject Matter Expert for Workers’ Compensation, you’ll partner with Product, Engineering, Analytics, and Claims Operations to turn the realities of claims handling into better products: clearer workflows, more useful data, and thoughtfully designed automation that helps claims teams make stronger decisions at scale.
Some of the problems you’ll solve:
🔍 Where does the Workers’ Compensation claims process create unnecessary delay, rework, or uncertainty? Map the claim lifecycle from FNOL through closure to identify friction points and improvement opportunities.
🧩 What information is missing, inconsistent, or difficult to use when claim decisions are made? Identify gaps in the injury, wage, medical, employer, and jurisdictional data claims teams need to make sound decisions.
📐 What does a high-quality, defensible Workers’ Compensation claim look like? Define practical standards for investigation, documentation, compensability, medical and indemnity handling, reserves, and return to work planning.
💸 Where are we losing time, money, or trust? Identify ways to reduce claim duration, improve outcomes and reserve accuracy, limit leakage and litigation exposure, and strengthen the injured-worker and employer experience.
🤖 Where can automation create real leverage without weakening claim quality or compliance? Identify workflows where structured data, intelligent routing, automation, or AI can improve consistency and speed while preserving human judgment and jurisdictional controls.
How you’ll make an impact:
🧭 Bring the real Workers’ Compensation claims process into product decisions. Translate claims expertise into product requirements, workflows, edge cases, and decision frameworks.
🔗 Connect the medical, operational, regulatory, and financial picture. Help teams understand how claim decisions affect medical spend, indemnity, reserves, return-to-work outcomes, litigation exposure, and loss performance.
🛠 Improve the inputs and outputs of the claims process. Shape how claim information is captured and structured, then improve the workflows, reporting, automation, and product experiences built from it.
🤝 Align teams around the same definition of quality. Partner across Product, Engineering, Analytics, Claims Operations, Finance, Customer Success, and Leadership to address root causes and drive improvements.
📊 Turn operational insight into measurable product improvements. Prioritize changes that improve claim outcomes—not just workflow activity.
🎓 Serve as a trusted internal authority on Workers’ Compensation claims. Guide teams through compensability, medical management, indemnity, return to work, reserving, documentation, and jurisdictional variation.
💬 Make complex claims concepts understandable and usable. Clearly communicate findings, tradeoffs, and recommendations across technical and non-technical audiences.
What we’re looking for
🧾 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.
We care more about deep Workers’ Compensation claims judgment and the ability to translate it into product impact than experience with any particular software or internal tool.
Benefits
👶 Family Leave: Maternity & paternity
Required skills
- machine learning
- data analytics
- artificial intelligence