Senior Medical Malpractice Claims Leader

Sedgwick; Texas; Vor Ort; USD 100.000 - 115.000; Vollzeit

Benefits dieser Stelle

Medical, dental, vision

401k and matching

PTO

Disability and life insurance

Zusammenfassung

Sedgwick is hiring a Sr. Claims Specialist for Professional Liability focusing on medical malpractice claims in New Jersey.

The role analyzes complex claims, coordinates investigations, manages reserves, and directs settlement and defense strategies to control costs while delivering high-quality service. The ideal candidate has extensive claims management experience, strong analytical skills, and a track record of effective client communication.

Qualifikationen

• 6 years of claims management experience or equivalent combination of education and experience required.
• Bachelor's degree from an accredited college or university preferred.

Aufgaben

• 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.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.

Kenntnisse

Claims management

Negotiation

Analytical thinking

Customer service

Ausbildung

Bachelor's degree

Professional certification

Tools

None

Jobbeschreibung

Sedgwick is hiring a Sr. Claims Specialist for Professional Liability focusing on medical malpractice claims in New Jersey.

The role analyzes complex claims, coordinates investigations, manages reserves, and directs settlement and defense strategies to control costs while delivering high-quality service. The ideal candidate has extensive claims management experience, strong analytical skills, and a track record of effective client communication.