Remote Senior Claims Lead - Professional Liability

Sedgwick; Lansing (MI); Remote; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with matching

PTO

Disability insurance

Life insurance

Employee assistance

Job summary

Sedgwick, a leader in risk and claims administration, seeks a Sr. Claims Specialist for Professional Liability to analyze complex claims and manage case workflows remotely across the United States.

The role emphasizes negotiation, reserves, and coordination with legal defense, supported by a bachelor’s degree and 6 years’ claims experience. Excellent communication and analytical skills are essential for success.

Qualifications

• Six (6) years of claims management experience or equivalent combination of education and experience required.
• 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

Responsibilities

• Analyze and process complex or technically difficult professional liability claims by investigating and gathering information to determine exposure and manage claims.
• Conduct or assign full investigations and provide reports for new events, claims and legal actions.
• Negotiate settlements up to designated authority level.
• Calculate reserves and monitor reserve adequacy throughout claim life.
• Recommend settlement strategies and present structured proposals to maximize settlements.
• Coordinate legal defense by assigning attorneys and reviewing invoices; ensure compliance with client guidelines.
• Utilize cost containment techniques and vendor partnerships to reduce claim costs.
• Identify fraud, subrogation, contribution, recovery opportunities.
• Represent company in depositions, mediations, and trial monitoring as needed.
• Maintain client communication and professional relationships.
• Ensure proper documentation and coding of claims; refer cases to supervisors as needed.
• Mentor assigned staff and delegate work.

Skills

Communication

MS Office

Analytical skills

Organizational skills

Negotiation

Interpersonal skills

Teamwork

Performance competencies

Education

Bachelor's degree

Licenses as required

Professional certification

Tools

Microsoft Office

Job description

Sedgwick, a leader in risk and claims administration, seeks a Sr. Claims Specialist for Professional Liability to analyze complex claims and manage case workflows remotely across the United States.

The role emphasizes negotiation, reserves, and coordination with legal defense, supported by a bachelor’s degree and 6 years’ claims experience. Excellent communication and analytical skills are essential for success.