Workers Comp, Lost Time Claims Subject Matter Expert

About Us: EvolutionIQ’s mission is to deliver state of the art technology that helps insurance claims teams make claims handling more accurate, fair, and efficient, so that more people impacted by injury or illness can continue their lives with dignity and stability. We are currently experiencing massive growth and to accomplish our goals, we are hiring world-class talent who want to help build and scale internally, and transform the insurance space. Our team is our #1 priority, and we have been named one of Inc.’s Best Workplaces 3 years in a row and Built In’s Best Places to work in 2025 and 2026!

Overview: EvolutionIQ is developing a cutting-edge Artificial Intelligence (AI) based product designed to enhance efficiency and accuracy for Workers' Compensation Adjusters. We are seeking highly experienced, Subject Matter Experts (SMEs) to partner with our Product and Engineering teams in the development of that product. The primary role of the SME will be to provide expert validation, feedback, and real-world context on the product's features, user experience, and the quality/relevance of the AI-generated outputs.

Key Responsibilities

• AI Output Validation: Critically assess the accuracy, relevance, completeness, and practical utility of the AI-generated summaries, recommendations, and data extractions against source medical documents (e.g., Provider Visit Notes, Attending Physician Statements, Medical Bills, etc.)
• Product Evaluation: Actively use and evaluate pre-release versions of the product’s features, leveraging your knowledge of claims handling and decision-making processes that [examiners/ adjusters] have.
• Data Labeling: Accurately and consistently label medical information within insurance claims data. This includes identifying key medical facts, diagnoses, treatments, and other relevant details.
• Prompt Editing: Leveraging claims-handling expertise to edit LLM prompts (no technical experience required for this).
• Workflow Insight: Provide detailed feedback on how the product integrates into existing daily claims management workflows, identifying pain points and opportunities for improvement.
• User Experience (UX) Input: Offer constructive criticism on the product's user interface and overall user experience to ensure it is intuitive for claims professionals.

Required Qualifications

• Professional Experience: Ideally 1-5+ years of recent, hands-on experience as a Worker’s Compensation, Lost Time Claims Adjuster (Bodily Injury/Liability focus).
• Technical Aptitude Comfortable working with computers and learning new software applications. Familiarity with data labeling tools or natural language processing (NLP) is a plus but not required.
• Critical Thinking: Exceptional ability to review complex documentation (medical, legal, financial) and critically evaluate the key pieces of information buried within and relevance.
• Communication Skills: Excellent written and verbal communication skills, with the ability to articulate feedback clearly to a non-claims audience (product and engineering team).
• Attention to Detail: Meticulous attention to detail and a commitment to accuracy in evaluation and validation of output.

Preferred Qualifications

• Experience in training, mentoring, or process improvement roles within a claims environment.
• Specific experience using AI or automation tools in a professional setting.

Compensation & Perks: This opportunity is part of a paid user research project focused on Workers’ Compensation claims expertise. Compensation will vary based on participation level, experience, and scope of involvement. Hours may increase depending on business needs. This project offers a unique opportunity to collaborate with a rapidly scaling AI Insurtech SaaS company.

EvolutionIQ appreciates your interest in our company as a place of employment. EvolutionIQ is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.