Remote Senior Medical Malpractice Claims Lead

Sedgwick; Pierre (SD); Remote; USD 110,000 - 120,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability

Life insurance

Employee assistance

Flexible spending or health savings

Job summary

Sedgwick, a leader in risk and claims administration, seeks a Sr. Claims Specialist, Medical Malpractice, to work remotely.

You’ll analyze complex claims, coordinate case management, and resolve costly matters with strategic settlements while maintaining high levels of service for clients. The role requires a bachelor’s degree and six years of claims experience, with deep knowledge of medical malpractice principles.

Qualifications

• Bachelor’s degree preferred; licenses as required.
• Six years of claims management experience required.
• In-depth knowledge of medical malpractice insurance principles and laws.

Responsibilities

• Analyzes and processes complex medical malpractice claims by investigating and gathering information to determine exposure.
• Conducts full investigations and provides reports of investigation.
• Negotiates settlements up to designated authority level.
• Calculates and assigns reserves; monitors reserve adequacy.
• Recommends settlement strategies and structured settlements when needed.
• Coordinates legal defense and reviews attorney invoices; ensures client guidelines.
• Identifies fraud, subrogation, recovery opportunities to reduce costs.
• Represent company in depositions, mediations, and trial monitoring.
• Communicates claim activity with clients and maintains professional relationships.
• Ensures proper documentation and coding of claims.

Skills

Negotiation

Communication

Analytical

Organizational skills

Team player

MS Office

Education

Bachelor's degree

Job description

Sedgwick, a leader in risk and claims administration, seeks a Sr. Claims Specialist, Medical Malpractice, to work remotely.

You’ll analyze complex claims, coordinate case management, and resolve costly matters with strategic settlements while maintaining high levels of service for clients. The role requires a bachelor’s degree and six years of claims experience, with deep knowledge of medical malpractice principles.