Remote Senior Medical Malpractice Claims Specialist

Sedgwick; Carson City (NV); Remote; USD 100,000 - 125,000; Full time

Job summary

Sedgwick is seeking a senior claims professional to analyze complex medical malpractice cases and drive cost-effective resolutions. You’ll manage exposure, coordinate investigations, and collaborate with clients to maintain high service levels.

Ideal candidates have 6+ years in claims management, a Bachelor’s degree (or equivalent), and professional certifications; strong analytical, negotiation, and judgement skills will help you lead settlements while protecting client interests.

Qualifications

• 6 years of claims management experience or equivalent combination of education and experience.
• Bachelor’s degree from an accredited college or university preferred. Licenses as required.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.

Skills

Analytical thinking

Negotiation skills

Judgement

Customer service

Education

Bachelor's degree

Professional certification

Job description

Sedgwick is seeking a senior claims professional to analyze complex medical malpractice cases and drive cost-effective resolutions. You’ll manage exposure, coordinate investigations, and collaborate with clients to maintain high service levels.

Ideal candidates have 6+ years in claims management, a Bachelor’s degree (or equivalent), and professional certifications; strong analytical, negotiation, and judgement skills will help you lead settlements while protecting client interests.