Disability Claims Adjudication Specialist

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Disability Claims & Underwriting Specialist
Type: Contract
Compensation: $80/hour
Location: Remote
Commitment: 20–40 hours/week

Role Responsibilities

• Design realistic scenarios involving short- and long-term disability claims, elimination periods, own-occupation and any-occupation definitions, residual and partial disability, offsets, recurrent disability, and claim duration management.
• Create work products such as claim determinations, benefit calculations, medical and vocational evidence summaries, transferable-skills analyses, return-to-work plans, and appeal decisions.
• Write "golden" reference responses at experienced disability-professional quality.
• Grade AI-generated responses against structured rubrics for definitional accuracy, evidentiary support, benefit-calculation correctness, and procedural fairness.
• Identify misapplied disability definitions, unsupported functional conclusions, missed offsets, incorrect benefit math, and failures to document the administrative record.
• Provide written feedback the research team uses to improve model behavior.

Qualifications

Must-Have

• 2+ years of professional experience in disability claims adjudication, disability underwriting, vocational rehabilitation, or leave and absence management.
• Experience with at least one program type, such as group short-term disability, group long-term disability, individual disability income, statutory disability, or life waiver of premium.
• Understanding of contract definitions, elimination periods, offsets, pre-existing-condition provisions, and maximum benefit periods.
• Ability to weigh medical, occupational, and financial evidence and articulate a defensible determination with a documented rationale.
• Excellent written analysis, balanced judgment, and high attention to detail.
• Ability to distinguish claim adjudication from treating-provider clinical decisions and from formal legal advice.

Preferred

• CRC, CDMS, CCM, CPDM, RN, or comparable clinical or vocational credential.
• Experience with ERISA administrative records, appeals, or litigation support.
• Individual disability income underwriting, including occupation class and financial underwriting.
• Social Security, workers compensation, or other-income offset coordination experience.
• Experience with FMLA, state leave programs, or ADA accommodation interaction.

Start Date

• Immediately; applications reviewed on a rolling basis.

Compensation & Legal

• Hourly contractor, Paid weekly via Stripe Connect.

Application Process (Takes 20–30 mins to complete)

• Upload resume
• AI interview based on your resume
• Submit form

Resources & Support

• For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
• For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.