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AI Claims Triage Analyst

Quilvex Systems

Remote · $100k – $130k / year · Full-time · Posted 5 months ago

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About the role

Insurance claims arrive as unstructured narratives — a claimant describing what happened in their own words, with photos, police reports, and medical records attached. Our triage system reads everything, classifies claim complexity, estimates reserve amounts, and routes each claim to the adjuster with the right expertise. You'll build the triage pipeline: extracting structured incident details from narrative claim descriptions, classifying claims by type, complexity, and fraud indicators, predicting initial reserve amounts from claim characteristics, and routing claims to specialized adjusters based on incident type and required expertise. Claims triage directly affects customer experience. Fast, accurate triage means the right adjuster handles the claim from day one — no transfers, no repeated questions, no delays. Slow triage means claimants wait while their file bounces between departments. You'll optimize for speed and accuracy simultaneously.

Fully remote.

Responsibilities

  • Extract structured incident details from narrative claim descriptions
  • Classify claims by type, complexity, and fraud risk indicators
  • Predict initial reserve amounts from claim characteristics and history
  • Route claims to specialized adjusters based on expertise matching
  • Monitor triage accuracy and optimize classification thresholds

Requirements

  • 3+ years in NLP or insurance technology
  • Strong scikit-learn and Python skills for text classification
  • SQL proficiency for claims database analysis
  • Understanding of insurance claims workflows and adjuster specializations
  • Experience with multi-class classification and routing optimization

Benefits

  • Fully remote — UK and EU time zones
  • 28 days PTO
  • Competitive salary with annual bonus
  • Improving claims experience for millions of policyholders

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Categories

AI & Machine Learning Engineers Automation & AI Workflows

Skills

python scikit-learn sql pandas langchain

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Job Type

Full-time

Level

Mid-Level

Language

English

Salary Range

$100k – $130k / year

AI Expertise

AI & Machine Learning Engineers Automation & AI Workflows

Skills

python scikit-learn sql pandas langchain statistics

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