Remote MedMal & Professional Liability Claims Specialist

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

Benefits offered by this job

Flexible schedule

Referral incentive

Agile environment

Career development

Benefits package

Job summary

Sedgwick, a global leader in risk and claims management, seeks a Professional Liability Claims Advisor (Remote) to adjudicate complex MedMal and professional liability claims from a telecommuting setup. You will investigate, evaluate coverage, and drive strategic resolutions while mentoring colleagues across a broad client portfolio.

In this remote role, expect Pacific Time hours, collaboration with defense counsel, and a focus on controlling costs while delivering exceptional client service and

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• 3-5 years of medical malpractice and professional liability claims management experience required.

Responsibilities

• Analyzes and processes complex MedMal and Professional Liability claims by investigating and gathering information to determine exposure.
• Conducts or assigns full investigations and provides investigation reports for new events, claims, and legal actions.
• Negotiates claim settlements up to designated authority level.
• Calculates reserves and monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and structures to maximize settlements.
• Performs coverage analysis and communicates with clients and defense counsel as needed.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Uses cost containment techniques including vendor partnerships to reduce totals.
• Identifies fraud, subrogation, recovery opportunities to reduce costs.
• Represents company in mediations and trial monitoring as needed.

Skills

Medical malpractice

Professional liability

Claims management

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

Sedgwick, a global leader in risk and claims management, seeks a Professional Liability Claims Advisor (Remote) to adjudicate complex MedMal and professional liability claims from a telecommuting setup. You will investigate, evaluate coverage, and drive strategic resolutions while mentoring colleagues across a broad client portfolio.

In this remote role, expect Pacific Time hours, collaboration with defense counsel, and a focus on controlling costs while delivering exceptional client service and