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

Sedgwick; Olympia (WA); On-site; USD 115,000 - 130,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k and matching

PTO

Disability and life insurance

Employee assistance

Job summary

Sedgwick in Washington state is seeking a Senior Claims Advisor for Professional Liability (E&O, D&O) to manage and resolve complex claims with expert case management and client service.

The role emphasizes investigating exposure, negotiating settlements, reserving, and coordinating legal defense, while ensuring cost-efficient outcomes and quality communication.

Join a leading risk and claims partner with comprehensive benefits and a culture of care.

Qualifications

• Ten years of complex claims management experience or equivalent combination of education and experience.
• Masters or Juris Doctorate degree from an accredited college or university preferred; licenses as required.
• Designations and/or licensing including but not limited to AIC, CPCU, ARM, AIC, CPHRM preferred.

Responsibilities

• Analyzes and processes complex or technically difficult liability claims by investigating to determine the exposure on the claim.
• 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
• Recommends settlement strategies
• Performs coverage analysis and opinion as part of the claim process
• 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
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

Skills

Claims management

Negotiation

Communication

Analytical skills

Discretion

Team collaboration

Education

Master's degree or JD preferred

Licenses (AIC/CPCU/ARM/AIC/CPHRM) preferred

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

PRIMARY PURPOSE OF THE ROLE: Manage and handle executive, error and omissions, and complex professional liability claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE:

• Analyzes and processes complex or technically difficult liability claims by investigating to determine the exposure on the claim
• 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
• Recommends settlement strategies
• Performs coverage analysis and opinion as part of the claim process
• 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
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

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), Certified Professional in Health Care Risk Management (CPHRM) preferred.

Skills:

• 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
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Excellent negotiation 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.

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 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