Senior Medical Malpractice Claims Expert

Sedgwick Claims Management Services Ltd; Long Beach (CA); On-site; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) with matching

PTO

Disability insurance

Life insurance

Employee assistance

Job summary

Sedgwick is seeking a Sr. Claims Specialist, Professional Liability, Medical Malpractice, in California to analyze complex claims and drive resolution with strong client service.

The role requires advanced claims experience, sharp analytical and negotiation skills, and the ability to coordinate legal defense, reserves, and settlements per client guidelines. Excellent communication, organization, and judgment are essential to manage high-exposure files while maintaining compliance with regulatory

Qualifications

• Bachelor’s degree and 6 years of claims management experience required.
• Professional certification as applicable to line of business preferred.
• Licenses as required by state or client.

Responsibilities

• Analyzes and processes complex medical malpractice claims to determine exposure.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and coordinates structured settlements with clients.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Maintains professional client relationships and ensures proper documentation of claim files.

Skills

Analytical thinking

Negotiation

Education

Bachelor's degree

Job description

Sedgwick is seeking a Sr. Claims Specialist, Professional Liability, Medical Malpractice, in California to analyze complex claims and drive resolution with strong client service.

The role requires advanced claims experience, sharp analytical and negotiation skills, and the ability to coordinate legal defense, reserves, and settlements per client guidelines. Excellent communication, organization, and judgment are essential to manage high-exposure files while maintaining compliance with regulatory