Virtual Insurance Professional

Role Title: Social Insurance Specialist Role Type: Contractor
Location: United States, Remote
Our team is engaging Social Insurance Specialists to participate in an impactful project supporting our customer's needs. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required — your domain knowledge is what matters.
Scope of Work Review and analyze AI-generated social insurance benefit claims, ensuring comprehensive evaluation of evidence and adherence to established statutory and regulatory guidelines.
Assess AI-generated eligibility and entitlement determinations for retirement, survivors, disability, and supplemental income programs, weighing complex evidence accurately.
Complete detailed benefit determinations and computations, and document rationales with clarity and precision for AI training.
Conduct quality assurance reviews of AI-generated claims decisions, pinpointing inconsistencies or errors according to agency policy and program standards (e.g., POMS).
Utilize specialized claims and records systems to access, update, and manage claim files and supporting documentation.
Simulate higher-level review decisions, providing expertise on reconsiderations, appeals, and overpayment or underpayment processes for AI training.
Deliver constructive written and verbal feedback to enhance AI model training accuracy and effectiveness.
Preferred Qualifications Proven expertise as a Social Insurance Specialist or equivalent, with strong experience in eligibility determination, benefit entitlement, and evidence gathering.
Familiarity with GS-0105: Social Insurance Administration functions, or related series such as GS-0996: Veterans Claims Examining and GS-0512: Internal Revenue Agent.
Demonstrated skill evaluating benefit claims and applying program rules in a regulated environment.
Experience using claims processing and case management systems, such as SSA’s MCS and MSSICS, or similar platforms.
Background in quality assurance for claims or similar processes within federal, state, or related agencies.
Ability to synthesize complex information and present informed decisions for higher-level review processes.

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