Senior Medical Malpractice Claims Specialist

Sedgwick; Idaho; On-site; USD 85,000 - 125,000; Full time

Job summary

Sedgwick is seeking a Sr. Claims Specialist in the United States with focus on professional liability and medical malpractice. You will analyze complex claims, coordinate investigations, and drive cost-effective resolutions while maintaining high client service standards.

The ideal candidate has a strong analytical mindset, negotiation skills, and the ability to manage high-exposure cases with precision and professionalism. This role emphasizes teamwork and adherence to company guidelines.

Qualifications

• 6 years of claims management experience or equivalent combination of education and experience.
• Bachelor's degree from an accredited college or university 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 and provide timely resolution.
• Conducts or assigns full investigation and provides reports relating to new events, claims, and legal actions.
• Calculates and assigns reserves; monitors reserve adequacy throughout the claim lifecycle.
• Recommends settlement strategies and presents structured settlement proposals to maximize settlement value.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Identifies fraud, subrogation, recovery opportunities to reduce total claim cost and improve outcomes.

Skills

Claims management

Negotiation

Analytical thinking

Regulatory compliance

Education

Bachelor's degree

Professional certification (lia)

Job description

Sedgwick is seeking a Sr. Claims Specialist in the United States with focus on professional liability and medical malpractice. You will analyze complex claims, coordinate investigations, and drive cost-effective resolutions while maintaining high client service standards.

The ideal candidate has a strong analytical mindset, negotiation skills, and the ability to manage high-exposure cases with precision and professionalism. This role emphasizes teamwork and adherence to company guidelines.