[Remote] AI/ML Data Scientist with in Claims/Insurance/NLP

Note: The job is a remote job and is open to candidates in USA. KPG99 INC is seeking a Senior Data Scientist specializing in AI, Machine Learning, and Natural Language Processing to support enterprise Risk Management and Claims Analytics. The role involves developing advanced predictive models and optimization solutions to mitigate risks and improve business outcomes.

Responsibilities

• Design, develop, deploy, and optimize machine learning models
• Build incident prioritization and claim severity prediction models
• Develop risk-scoring frameworks for proactive risk identification
• Perform feature engineering across structured and unstructured datasets
• Monitor model performance, drift, retraining requirements, and scoring quality
• Develop NLP solutions for claims and incident narrative analysis
• Build text classification and language-processing pipelines
• Leverage Large Language Models (LLMs) to extract business insights
• Generate explainable AI outputs and risk-driver analysis
• Apply AI techniques to improve operational decision-making
• Develop predictive analytics and statistical modeling solutions
• Build record-linkage and entity-resolution models where unique identifiers do not exist
• Support large-scale data analysis across enterprise datasets
• Work with structured, semi-structured, and unstructured data sources
• Partner with Risk Management, Legal, Data Engineering, Data Governance, BI, and MLOps teams
• Translate business requirements into technical solutions
• Present findings and recommendations to technical and executive stakeholders
• Mentor junior Data Scientists and contribute to team best practices
• Create documentation covering methodology, assumptions, validation approaches, and limitations
• Support model governance and explainability requirements
• Ensure compliance with data governance, privacy, and security standards

Skills

• Claims Analytics
• Insurance Risk Modeling
• Incident Prediction
• Fraud Analytics
• Severity Modeling
• Explainable AI (SHAP, LIME, etc.)
• Hospitality Industry Analytics
• Travel Industry Analytics
• Data Governance
• PII Handling
• Data Architecture
• Databricks
• Snowflake
• Natural Language Processing
• Text Classification
• NLP Pipelines
• LLM Applications
• Claims / Incident Narrative Analysis
• Operations Research & Optimization
• Develop optimization solutions utilizing: Linear Programming (LP), Integer Programming (IP), Mixed Integer Programming (MIP), CPLEX, Gurobi
• Apply mathematical optimization techniques to business and operational challenges
• Support resource allocation and decision optimization initiatives
• Develop predictive analytics and statistical modeling solutions
• Build record-linkage and entity-resolution models where unique identifiers do not exist
• Support large-scale data analysis across enterprise datasets
• Work with structured, semi-structured, and unstructured data sources
• 5+ years of Data Science, Machine Learning, Operations Research, or related experience
• 2+ years may be acceptable with a relevant PhD
• Proven experience building production-grade machine learning solutions
• Strong experience with predictive analytics and risk modeling
• Experience deploying models into enterprise environments
• Experience working with large datasets and scalable architectures
• Agile delivery experience
• Python
• SQL
• Spark
• Master's Degree in: Computer Science, Statistics, Industrial Engineering, Operations Research, Related Technical Field
• PhD in a relevant discipline

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