Senior Medical Malpractice Claims Specialist

Sedgwick; Arizona; On-site; USD 70,000 - 95,000; Full time

Job summary

Sedgwick is seeking a Sr. Claims Specialist, Professional Liability (Medical Malpractice) to analyze complex claims, determine exposure, and coordinate resolutions with high service standards.

You will manage case costs while delivering timely outcomes. Ideal candidates bring strong analytical and negotiation skills, extensive medical malpractice experience, and the ability to work with clients and defense counsel to optimize settlements and preserve relationships.

Qualifications

• 6 years of claims management experience or equivalent combination of education and experience required.
• Bachelor's degree 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 exposure; manages claims through action plans to resolution.
• Conducts or assigns full investigation and provides investigation reports for new events, claims and legal actions.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; proposes structured settlements to maximize settlement.
• Coordinates legal defense by assigning attorneys, coordinating support for investigations, and reviewing attorney invoices.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall claim cost for clients.
• Identifies and investigates fraud, subrogation, contribution, recovery opportunities to reduce total claim cost.
• Represent company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity with clients; maintains professional client relationships.
• Ensures claim files are properly documented and coding is correct.
• Performs other duties as assigned; supports the organization's quality programs.

Skills

Analytical skills

Negotiation skills

Education

Bachelor's degree

Licenses as required

Professional certification as applicable

Job description

Sedgwick is seeking a Sr. Claims Specialist, Professional Liability (Medical Malpractice) to analyze complex claims, determine exposure, and coordinate resolutions with high service standards.

You will manage case costs while delivering timely outcomes. Ideal candidates bring strong analytical and negotiation skills, extensive medical malpractice experience, and the ability to work with clients and defense counsel to optimize settlements and preserve relationships.