Remote MedMal & PL Claims Advisor

Sedgwick; Sacramento (CA); Remote; USD 100,000 - 145,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development and growth

Job summary

Sedgwick is seeking a Professional Liability Claims Advisor (Remote) to adjudicate and manage complex Medical Malpractice and professional liability claims for clients across industries. This role emphasizes investigation, coverage analysis, negotiation, and strategic resolutions within a supportive, flexible remote environment.

You'll collaborate with defense counsel, mentor others, and leverage a broad network to deliver exceptional client service while maintaining adherence to client

Qualifications

• 3–5 years of medical malpractice and professional liability claims management experience.

Responsibilities

• Analyzes and processes complex MedMal and Professional Liability claims by investigating and gathering information to determine exposure; manages claims to 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 reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and brings structured proposals to maximize settlement.
• Performs coverage analysis and communicates with clients and attorneys.
• Coordinates legal defense by assigning attorney and reviewing invoices; monitors counsel for compliance.
• Uses cost containment techniques including vendor partnerships to reduce claim costs.
• Identifies fraud/subrogation opportunities to reduce total claim cost.
• Represents company in mediations and trial monitoring as needed.
• Communicates claim activity to clients and maintains professional relationships.
• Ensures files are properly documented and claims coding is correct.

Skills

Claims management

Analytical thinking

Negotiation

Client service

Education

Bachelor's degree preferred

High School Diploma or GED required

Job description

Sedgwick is seeking a Professional Liability Claims Advisor (Remote) to adjudicate and manage complex Medical Malpractice and professional liability claims for clients across industries. This role emphasizes investigation, coverage analysis, negotiation, and strategic resolutions within a supportive, flexible remote environment.

You'll collaborate with defense counsel, mentor others, and leverage a broad network to deliver exceptional client service while maintaining adherence to client