Senior Medical Malpractice Claims Specialist

Sedgwick; Phoenix (AZ); 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 is hiring a Sr. Claims Specialist to analyze highly complex medical malpractice claims and drive resolutions in a cost‑effective manner. You will coordinate case management, manage reserves, and collaborate with clients and legal teams to ensure high‑quality service.

Ideal candidates have extensive claims management experience, strong analytical and negotiation skills, and a commitment to timely, precise claim handling in a fast‑paced environment.

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.
• Conducts or assigns full investigation and provides investigation reports for new events, claims and actions.
• Calculates and assigns timely reserves to claims; monitors reserve adequacy.
• Recommends settlement strategies; presents structured settlement proposals to maximize settlement.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Uses cost containment techniques including vendor partnerships to reduce claim costs.
• Identifies fraud, subrogation, recovery opportunities to reduce total claim cost.
• Represent the company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity with the client and maintains professional relationships.

Skills

6 years claims management experience

Education

Bachelor's degree

Job description

Sedgwick is hiring a Sr. Claims Specialist to analyze highly complex medical malpractice claims and drive resolutions in a cost‑effective manner. You will coordinate case management, manage reserves, and collaborate with clients and legal teams to ensure high‑quality service.

Ideal candidates have extensive claims management experience, strong analytical and negotiation skills, and a commitment to timely, precise claim handling in a fast‑paced environment.