Remote | Insurance Claims Review Specialist — $60–$90/hour

We are sharing a specialised part-time consulting opportunity for professionals experienced in insurance claims handling, claims operations, coverage review, claims documentation, and structured claims workflow analysis. This role supports current and upcoming remote consulting opportunities focused on structured claims review, insurance workflow analysis, documentation assessment, scenario development, and high-quality project execution. Selected professionals will apply their claims expertise to review realistic claims scenarios, evaluate documentation requirements, prepare structured written outputs, and support accurate, evidence-based claims workflow tasks.

Key Responsibilities

Professionals in this role may contribute to:

• Claims Intake & Triage Review
• Review claims scenarios involving FNOL intake, required-field checklists, routing rules, coverage questions, and claim assignment workflows
• Assess claims documentation for completeness, accuracy, and alignment with defined handling requirements
• Support structured review of claim intake materials, triage decisions, and assignment logic
• Identify required information, missing details, documentation gaps, and expected next steps
• Coverage, Reserving & Adjudication Support
• Review coverage analysis materials, policy interpretation notes, reserve memos, adjuster notes, settlement letters, and denial letters
• Evaluate claim handling scenarios involving reserve setting, settlement review, denial decisions, and documented claim outcomes
• Prepare clear written explanations for claims decisions based on provided materials and defined criteria
• Support structured review of adjudication workflows across property, casualty, workers compensation, specialty, or related insurance lines
• Specialized Claims Workflow Review
• Review scenarios involving subrogation screening, SIU referrals, fraud indicators, litigation file management, and required-document lists
• Evaluate claims files against documented rules, handling standards, and workflow expectations
• Create structured review criteria based on verifiable claim facts and source materials
• Maintain accuracy, consistency, and professional judgment across submitted work

Ideal Profile

• Strong candidates may have:
• 3+ years of experience as a claims adjuster, claims operations specialist, claims examiner, claims supervisor, or related insurance claims professional
• Experience with one or more claim types such as auto, property, general liability, workers compensation, medical, specialty lines, or related coverage areas
• Strong understanding of claims intake, coverage analysis, policy interpretation, reserving practice, claim documentation, settlement review, or denial workflows
• Familiarity with claims systems such as Guidewire ClaimCenter, Duck Creek, legacy carrier systems, or similar platforms
• Comfort reading and preparing claims artifacts such as FNOLs, coverage opinions, reserve memos, adjuster notes, settlement letters, denial letters, and litigation file materials
• Strong written communication skills and ability to explain claims reasoning clearly
• Ability to follow structured instructions and produce evidence-based work
• Educational Background
• A degree or professional background in insurance, risk management, business administration, legal studies, claims management, finance, healthcare administration, or a related field is helpful
• Equivalent practical experience in claims adjusting, claims operations, claims supervision, coverage review, or insurance documentation workflows is also highly relevant
• Nice to Have
• Adjuster licensure in at least one U.S. state
• Experience with subrogation, SIU, fraud investigation, litigation management, or complex claims handling
• Experience reviewing claim files, coverage opinions, reserve documentation, or settlement materials
• Familiarity with P&C, workers compensation, medical claims, specialty lines, or commercial claims workflows
• Strong attention to detail in documentation-heavy claims environments
• Why This Opportunity
• Apply insurance claims expertise to structured remote project work
• Contribute to high-quality claims review, documentation assessment, and workflow analysis
• Work on flexible, project-based assignments aligned with your professional background
• Use your claims judgment in a focused, detail-oriented consulting environment
• Remote structure with competitive hourly compensation
• Contract Details
• Independent contractor role
• Fully remote with flexible scheduling
• Part-time commitment depending on project availability
• Competitive rates between $60–$90 per ho

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