Claims Advisor, Professional Liability | E&O, D&O

Sedgwick Claims Management Services Ltd; Florida; Hybrid; USD 115,000 - 130,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flexible spending or health savings

Job summary

Sedgwick is seeking a Claims Advisor, Professional Liability to analyze and manage complex D&O, EPL and E&O liability claims. You will investigate, determine exposure, and drive outcomes through structured settlement strategies and reserves.

The role requires extensive claims experience, strong negotiation, analytical skills, and collaboration with legal support to ensure compliance and optimal client results.

Qualifications

• Ten (10) years of complex claims management experience or equivalent combination of education and experience required.
• Masters or Juris Doctorate degree preferred.
• Licenses and/or designations such as AIC, CPCU, ARM, AIC preferred.

Responsibilities

• Analyzes and processes complex or technically difficult D&O, EPL and E&O liability claims.
• Negotiates claim settlements up to designated authority level.
• Calculates reserves and monitors reserve adequacy throughout claim life.
• Coordinates legal defense and reviews attorney invoices for compliance with client guidelines.
• Identifies opportunities for cost containment and fraud reduction.

Skills

Complex claims management

Negotiation skills

Analytical thinking

Oral and written communication

Team collaboration

PC literacy/Microsoft Office

Education

Masters or Juris Doctorate

Licenses (AIC, CPCU, ARM, AIC)

Tools

Microsoft Office

Job description

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

Claims Advisor, Professional Liability | E&O, D&O

ARE YOU AN IDEAL CANDIDATE?

ESSENTIAL RESPONSIBILITIES OF THE ROLE MAY INCLUDE:

• Analyzes and processes complex or technically difficult D&O, EPL and E&O liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Negotiates claim settlement up to designated authority level.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Performs coverage analysis and opinion as part of the claim process including all necessary correspondence.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Delegates work and mentors others.

QUALIFICATIONS

Education & Licensing: Ten (10) years of complex claims management experience or equivalent combination of education and experience required Masters or Juris Doctorate degree from an accredited college or university preferred. Licenses as required. Designations and/or licensing including but not limited to Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), Associate in Insurance Claims (AIC) preferred.

Skills & Knowledge

In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business Extensive knowledge and comprehension of insurance coverage Claims expertise in errors and omissions, directors and officers,, and/or cyber liability Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Excellent negotiation skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies 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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $115,000 to $130,000.

A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

• medical
• dental
• vision
• 401k and matching
• PTO
• disability and life insurance
• employee assistance
• flexible spending or health savings account
• other additional voluntary benefits

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

For more, see sedgwick.com