Product SME - Workers Compensation

Assured•Palo Alto, CA

8d•$120,000 - $140,000•Remote

About The Position

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.

Requirements

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.

Responsibilities

Map the claim lifecycle from FNOL through closure to identify friction points and improvement opportunities.
Identify gaps in the injury, wage, medical, employer, and jurisdictional data claims teams need to make sound decisions.
Define practical standards for investigation, documentation, compensability, medical and indemnity handling, reserves, and return to work planning.
Identify ways to reduce claim duration, improve outcomes and reserve accuracy, limit leakage and litigation exposure, and strengthen the injured-worker and employer experience.
Identify workflows where structured data, intelligent routing, automation, or AI can improve consistency and speed while preserving human judgment and jurisdictional controls.
Translate claims expertise into product requirements, workflows, edge cases, and decision frameworks.
Help teams understand how claim decisions affect medical spend, indemnity, reserves, return-to-work outcomes, litigation exposure, and loss performance.
Shape how claim information is captured and structured, then improve the workflows, reporting, automation, and product experiences built from it.
Partner across Product, Engineering, Analytics, Claims Operations, Finance, Customer Success, and Leadership to address root causes and drive improvements.
Prioritize changes that improve claim outcomes—not just workflow activity.
Guide teams through compensability, medical management, indemnity, return to work, reserving, documentation, and jurisdictional variation.
Clearly communicate findings, tradeoffs, and recommendations across technical and non-technical audiences.