Senior Medical Malpractice Claims Specialist

Sedgwick; Clifton (TX); On-site; USD 75,000 - 120,000; Full time

Job summary

Sedgwick is seeking a skilled professional to analyze and manage complex medical malpractice claims involving severe exposure. You will coordinate investigations, set reserves, and guide settlement strategies to achieve timely, cost-effective resolutions while maintaining exceptional client service.

The ideal candidate has extensive claims management experience, strong analytical and negotiation abilities, and a commitment to quality service.

Qualifications

• 6 years of claims management experience or equivalent
• Bachelor's degree preferred. Licenses as required.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyzes and processes complex medical malpractice claims and researches exposure to determine resolution strategy.
• Conducts investigations and provides investigation reports for new events, claims, and legal actions.
• Calculates reserves and monitors reserve adequacy through the claim lifecycle.
• Recommends settlement strategies and structured settlements to optimize cost and outcomes.
• Coordinates defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Applies cost containment techniques and leverages vendor partnerships to reduce claim costs.
• Identifies potential fraud, subrogation, or recovery opportunities to reduce total costs.
• Represents Sedgwick in depositions, mediations, and trial monitoring as needed.
• Maintains professional client relationships and accurate claim documentation.

Skills

Claims management

Analytical skills

Negotiation

Client communication

Education

Bachelor's degree preferred

Job description

Sedgwick is seeking a skilled professional to analyze and manage complex medical malpractice claims involving severe exposure. You will coordinate investigations, set reserves, and guide settlement strategies to achieve timely, cost-effective resolutions while maintaining exceptional client service.

The ideal candidate has extensive claims management experience, strong analytical and negotiation abilities, and a commitment to quality service.