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

Sedgwick; Florida; On-site; USD 115,000 - 130,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401k with matching

PTO

Disability & Life Insurance

Employee Assistance

FSA / HSA

Other voluntary benefits

Job summary

Sedgwick is seeking an experienced Claims Advisor for Professional Liability | E&O, D&O in Florida. You will analyze and manage complex D&O/EPL/E&O claims, coordinate legal defenses, and negotiate settlements while maintaining client relationships and precise reserves throughout the life of each claim.

The ideal candidate has a strong background in professional liability claims, licensing, and professional designations, with a commitment to cost containment and high-quality investigations.

Qualifications

• 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), CPCU, ARM, AIC preferred.

Responsibilities

• Analyzes and processes complex or technically difficult D&O, EPL and E&O liability claims by investigating and gathering information to determine exposure on the claim; manages claims through action plans to resolution.
• Conducts investigations and provides reports pertaining to new events, claims and legal actions.
• Negotiates claim settlements up to designated authority level.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and presents structured settlement proposals to maximize settlements.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.

Skills

Complex claims mgmt

Insurance knowledge

D&O/E&O/Cyber liability

Negotiation

Communication

Teamwork

Education

Masters or JD degree

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
• other additional voluntary benefits

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! 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.