Product SME - Workers Compensation

Job description

Assured is on a mission to modernize insurance. Claims processing (i.e. should we pay this claim?), while often overlooked, is the foundation of the entire industry. It’s currently highly manual, involving phone calls, faxes, and gut instinct, costing tens of billions of dollars a year. We can do better. At Assured, we provide large insurers with the software solutions they need to win in a modern, technology-driven world. From self-service claim-filing software to backend fraud detection, we’re the engine that powers claims processing for some of the largest insurers in the world. The challenges we face are deep and diverse, from creating digital experiences that provide comfort and clarity to claimants at their most stressed and vulnerable to orchestrating large-scale ML-driven decision-making on billions of dollars of claims payments, life at Assured is dynamic, collaborative, and rewarding. 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: 🤑 Competitive Compensation: Competitive salary and equity packages for all employees 🏥 Healthcare Plan: Platinum medical, dental, and vision 🛡️ Free life insurance: Including long-term disability & short-term disability 🏄 Unlimited PTO: Uncapped vacation days & paid holidays 👶 Family Leave: Maternity & paternity 📈 401(k) Contribution: Assured contributes 3% of your income, even if you don't contribute 🏠 WFH Benefits: Lunch on us 2x/week, monthly phone stipend & other home office perks 👪 Health FSAs & HSAs: Pre-tax accounts for out-of-pocket medical expenses 🤝 Team events & Offsites: We're remote, but we regularly get together **We have been made aware of individuals falsely posing as recruiters from Assured Insurance Technologies Inc. Please note that we only contact candidates from official @assured.claims http://assured.claims email addresses and all interviews are conducted through verified company channels. If you are unsure whether a message is legitimate, please contact us directly at recruiting-ops@assured.claims before sharing any personal information** Our Commitment: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, sex, gender, gender expression, sexual orientation, age, marital status, veteran status, or disability status. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment. Please contact us to request accommodation.