Insurance Claims Analyst / Specialist (Remote / Freelance) — coverage determination and claim outcome classification via policy/claim review
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ClassificationPerformed independent policy and claims analysis for U.S. auto insurance by extracting relevant coverage information and determining coverage parameters. Applied state-specific negligence and regulatory rules to classify claims outcomes and validate which provisions apply. Produced precise, citation-based decisions with documented rationales for approvals, denials, and payout evaluations. • Reviewed U.S. auto policy language to identify applicable clauses, exclusions, and endorsement stacking effects • Classified coverage determinations (e.g., collision vs. comprehensive) using regulatory and policy criteria • Conducted quality checks on claim files to ensure accuracy of policy citations and payout calculations • Documented structured analytical rationale for downstream data/policy decision use