Insurance Claim Data Scientist

About this role

Job Description
Location:
New York, NY

• Remote

Purpose
The Sr Data Scientist will design and implement machine learning and NLP solutions for a claims and incident mitigation analytics project. This role will help risk management teams identify high-risk incidents earlier, classify claims by likely severity and financial impact, and provide explainable insights that support faster intervention.


Position Responsibilities

• Translate risk management business requirements into well-defined data science solutions, including incident prioritization and claim severity classification.
• Profile, clean, and prepare claims and incident data for analytics, modeling, and scoring.
• Develop feature engineering logic using structured and unstructured claims and incident data.
• Apply NLP and text-processing techniques to claim and incident narratives to extract useful risk signals.
• Develop record-linkage approaches to connect incidents and claims when a clean unique identifier is not available.
• Build and validate models that rank incidents by likelihood of becoming claims or requiring Risk Management intervention.
• Build and validate claim severity models that classify claims by likely financial impact and high-dollar claim risk.
• Generate explainability outputs, including key risk drivers and business-readable reasons for flagged incidents or claims.
• Collaborate with Risk Management, Legal, Data Engineering, BI, Data Governance, and MLOps partners to deliver usable business outputs.
• Monitor model performance, drift, scoring quality, and retraining needs.
• Document modeling assumptions, feature logic, validation results, limitations, and handoff requirements.
• Ensure data science work follows data governance expectations, including appropriate handling of PII and sensitive fields.
• Present findings, model results, and recommendations to business and technical stakeholders in a clear, actionable manner.

**Experience And Qualifications...