Domain Expert | Insurance: Claims Processing & Coverage

Description About Factify AI agents are starting to make decisions in regulated enterprises, including US banks and insurers. Factify turns an organization's policies, documents and real-world practice into a sealed, executable rulebook that governs how those agents decide. Every decision is traceable, auditable and ratified by the people who own the process. The role You will be our US insurance expert. You will map how critical decisions are really made inside US carriers, starting with how claims are adjudicated and how coverage is interpreted, and turn that judgment into explicit, testable rules. Those rules need to hold up with adjusters, auditors and state regulators. As our work expands, you will cover more of the carrier's critical processes. What you'll do Map claims processes end to end: first notice of loss, triage, coverage verification, investigation, adjudication, reserving, settlement and recovery. Map other critical insurance processes as customer needs arise, using your own experience of how they run in practice. Analyze policy forms, endorsements, exclusions and claims manuals. Identify contradictions and ambiguity between documents and between documents and practice. Translate coverage interpretation and authority limits into structured rules, including SIU and fraud indicators, escalation triggers and state-mandated handling timelines. Build test cases and golden-label datasets (covered / not covered / refer, with evidence) across lines such as property, a