NexaCare Systems · AI Claims Automation Specialist
Claims Rules Documentation Associate
6 weeks · 10 hrs/week · Remote · Foundation
NexaCare Systems is a fictional simulated work environment created for the Jay Health Work Experience Programme. It is not a real or verified employer, and this programme is an educational work-experience placement, not employment.
Programme overview
Practise translating claim-review guidance into clear, traceable rule statements, with examples, exceptions and version notes that another reviewer can understand and apply.
Claims Rules Documentation Associate Work Lab
The Claims Rules Documentation Associate Work Lab programme scope centres on turning reviewed claims into clear rule statements. Its intended outputs include versioned claims rulebook, worked rule examples, rule clarification and exception register.
What you will do: Claims Rules Documentation Associate Work Lab
- Extract rules from benefit and authorisation guidance
- Write rule statements with worked examples
- Check for contradictions and document clarification requests
Through role-focused educational assignments at NexaCare Systems, you will work through case briefs, document the evidence behind your decisions and prepare work samples relevant to turning reviewed claims into clear rule statements.
Work you will prepare for review
- Versioned claims rulebook
- Worked rule examples
- Rule clarification and exception register
Methods you will practise
- Rule documentation templates
- Version and change logs
Your weekly work cycle
- Develop and revise your versioned claims rulebook
- Submit progress on your worked rule examples with evidence and outstanding questions
- Discuss turning reviewed claims into clear rule statements findings in a supervisor review and record agreed next steps
Feedback and improvement. Your Claims Rules Documentation Associate assignments will be reviewed against the programme’s assessment criteria. You will explain your approach, discuss corrections and refine your deliverables before including permitted samples in your portfolio. The programme runs for 6 weeks, with an expected commitment of 10 hours per week; agreed assignments and review arrangements are confirmed in your enrolment offer.
Role description
Purpose of the role. The Claims Rules Documentation Associate programme develops role-specific judgement and professional work samples through turning reviewed claims into clear rule statements. The emphasis is on explaining your approach, producing clear evidence and improving work in response to supervisor feedback.
Work environment. A remote educational Claims Rules Documentation Associate programme set in the fictional NexaCare Systems environment, with role-focused case briefs, structured assignments and supervisor review.
Day-to-day responsibilities
- Extract rules from benefit and authorisation guidance
- Write rule statements with worked examples
- Check for contradictions and document clarification requests
Weekly responsibilities
- Develop and revise your versioned claims rulebook
- Submit progress on your worked rule examples with evidence and outstanding questions
- Discuss turning reviewed claims into clear rule statements findings in a supervisor review and record agreed next steps
Expected deliverables
- Versioned claims rulebook
- Worked rule examples
- Rule clarification and exception register
Reporting and supervision. The Claims Rules Documentation Associate programme scope includes an assigned supervisor reviewing role-specific deliverables, explaining corrections and assessing work against the criteria in your enrolment offer.
Tools and methods relevant to this programme
- Rule documentation templates
- Version and change logs
Requirements
Qualifications or professional background
- Health, health-informatics, data or insurance background
Required skills
- Analytical thinking
- Spreadsheet confidence
- Written documentation
Preferred skills
- Basic understanding of how rule-based or AI systems work
- Interest in health data
Previous experience. No previous experience required.
Digital literacy. Comfortable using web applications, spreadsheets and online communication tools.
Communication. Clear written English and timely responses to team messages and supervisor feedback.
Availability. 10 hours per week for 6 weeks, including scheduled reviews.
Technical requirements. A laptop or desktop computer, a modern browser and a stable internet connection.
Professional and ethical boundaries
- Educational casework only; no employment, real patient care, payer transactions or production system access is implied
- Use only fictional or authorised educational material; do not upload real patient or confidential employer information
- Specialist software, live integrations and dedicated role-specific workflows are not included in the current platform
Expected workload
Hours per week. 10 hours.
Assignment scope. Role-specific case briefs and deliverables focused on turning reviewed claims into clear rule statements. Assignment volume and due dates are confirmed in the enrolment offer within the 10-hour weekly commitment.
Deadlines and reporting. Tasks carry individual due dates; a weekly summary is due at the end of each week.
Meetings. One weekly team stand-up and one supervisor review session.
Attendance. Check in and out of the work lab for each working session.
How performance is evaluated
- Accuracy and relevance of versioned claims rulebook
- Evidence and reasoning in worked rule examples
- Documentation quality and professional boundaries
- Deadline adherence and response to feedback
Benefits
- Practical work-experience programme
- Access to Remote Career Launchpad
- Free mentor access according to the programme's mentoring arrangements
- Access to the Jay Health job board
- 10% discount on eligible Jay Health courses
- Supervisor feedback
- Opportunity to build a portfolio of permitted work samples
- Performance-based reward eligibility, where applicable (conditional, not guaranteed)
Learning outcomes
By the end of the programme you should be able to:
- Explain the key decisions and standards involved in turning reviewed claims into clear rule statements
- Prepare professional versioned claims rulebook
- Prepare professional worked rule examples
- Prepare professional rule clarification and exception register
- Use supervisor feedback to improve the clarity, accuracy and completeness of your work
Selection process
- Application review
- Interview
- Role-relevant assessment
- Acceptance decision
- Enrolment and payment of the ₦20,000 enrolment fee (only after acceptance)
- Onboarding