Senior Medical Malpractice Claims Specialist

American Association of Legal Nurse Consultants (AALNC); Chelsea (MI); On-site; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flex spending or HSA

Other voluntary benefits

Job summary

Sedgwick is seeking a Sr. Claims Specialist in Medical Malpractice to analyze complex claims and coordinate resolutions within company standards and client requirements.

The ideal candidate will bring strong analytical and negotiation skills, experience managing high-exposure cases, and the ability to lead case workups, reserve assessments, and settlement recommendations while maintaining exceptional customer service.

Qualifications

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

Responsibilities

• Analyzes and processes complex medical malpractice claims by investigating and gathering information to determine exposure.
• Calculates and assigns reserves, monitors adequacy throughout claim life.
• Recommends settlement strategies and may propose structured settlements to maximize value.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures client guidelines are followed.
• Identifies opportunities to reduce cost through vendor partnerships and cost containment techniques.
• Represents company in depositions, mediations, and trial monitoring as needed.
• Maintains professional client relationships and ensures proper documentation and coding of claims.

Skills

Analytical skills

Negotiation skills

Claims management experience

Customer service orientation

Education

Bachelor's degree or equivalent

Professional certification preferred

Job description

Sedgwick is seeking a Sr. Claims Specialist in Medical Malpractice to analyze complex claims and coordinate resolutions within company standards and client requirements.

The ideal candidate will bring strong analytical and negotiation skills, experience managing high-exposure cases, and the ability to lead case workups, reserve assessments, and settlement recommendations while maintaining exceptional customer service.