Senior Medical Malpractice Claims Specialist, CA

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

Job summary

Sedgwick is seeking a Senior Claims professional to analyze complex medical malpractice claims and coordinate case management to achieve timely and cost-effective resolutions. The role requires handling high exposure matters with strong analytical and negotiation skills.

Ideal candidates will manage reserves, conduct thorough investigations, and coordinate defense teams while maintaining excellent client service standards. A comprehensive benefits package is provided in addition to salary.

Qualifications

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

Responsibilities

• Analyzes and processes complex or technically difficult medical malpractice claims; manages claims through plans to timely resolution.
• Conducts or assigns full investigation and provides investigation reports.
• Calculates reserves and monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and structured settlements when appropriate.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures client guidelines are followed.

Skills

Claims management

Negotiation

Analytical thinking

Education

Bachelor's degree

Professional certification (line of business)

Job description

Sedgwick is seeking a Senior Claims professional to analyze complex medical malpractice claims and coordinate case management to achieve timely and cost-effective resolutions. The role requires handling high exposure matters with strong analytical and negotiation skills.

Ideal candidates will manage reserves, conduct thorough investigations, and coordinate defense teams while maintaining excellent client service standards. A comprehensive benefits package is provided in addition to salary.