Senior Medical Malpractice Claims Specialist

Sedgwick; New York (NY); On-site; USD 100,000 - 115,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flexible spending or health savings

Job summary

Sedgwick, a leading provider of specialized claims solutions, is seeking an experienced Sr. Claims Specialist for medical malpractice in New Jersey.

The role focuses on analyzing complex claims, coordinating investigations, and managing total claim costs while delivering high levels of customer service. Ideal candidates bring strong analytical and negotiation skills, meet licensing requirements, and possess a track record of providing timely, cost-effective resolutions.

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 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 to timely resolution.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney and reviewing invoices; ensures compliance with client guidelines.
• Uses cost containment techniques including vendor partnerships to reduce overall claim cost.

Skills

Analytical skills

Negotiation skills

Customer service

Education

Bachelor's degree

Job description

Sedgwick, a leading provider of specialized claims solutions, is seeking an experienced Sr. Claims Specialist for medical malpractice in New Jersey.

The role focuses on analyzing complex claims, coordinating investigations, and managing total claim costs while delivering high levels of customer service. Ideal candidates bring strong analytical and negotiation skills, meet licensing requirements, and possess a track record of providing timely, cost-effective resolutions.