Sr. Claims Specialist, Medical Malpractice | Professional Liability

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

As a Sr. Claims Specialist, Medical Malpractice | Professional Liability, your primary purpose will be to analyze complex or technically difficult medical malpractice claims, provide resolution of highly complex nature and/or severe injury claims, coordinate case management within Company standards, industry best practices and specific client service requirements, and manage the total claim costs while providing high levels of customer service.

Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost-effective claim resolutions while maintaining a high level of customer service.

Key responsibilities include:

• Analyzing and processing complex or technically difficult medical malpractice claims
• Conducting or assigning full investigation and providing report of investigation pertaining to new events, claims and legal actions
• Calculating and assigning timely and appropriate reserves to claims
• Recommending settlement strategies
• Coordinating legal defense
• Using appropriate cost containment techniques
• Identifying and investigating for possible fraud, subrogation, contribution, recovery, and case management opportunities
• Representing Company in depositions, mediations, and trial monitoring as needed
• Communicating claim activity and processing with the client
• Ensuring claim files are properly documented and claims coding is correct

Qualifications:

• 6 years of claims management experience or equivalent combination of education and experience required
• Bachelor's degree from an accredited college or university preferred
• Licenses as required
• Professional certification as applicable to line of business preferred

Work environment requirements include:

• Physical: Computer keyboarding
• Auditory/visual: Hearing, vision and talking
• Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines