Senior Medical Malpractice Claims Specialist – Complex Loss

Sedgwick; Yuma (AZ); On-site; USD 70,000 - 100,000; Full time

Job summary

Sedgwick in Arizona seeks a Sr. Claims Specialist, Medical Malpractice, to analyze complex claims, coordinate case management, and control costs while delivering high levels of service.

Ideal candidates have extensive experience in medical malpractice, strong analytical and negotiation skills, and a commitment to timely resolutions and client communication. This role offers growth and the chance to impact outcomes in a respected company.

Qualifications

• 6 years of claims management experience or equivalent.
• Bachelor's degree from an accredited college or university preferred; licenses as required.
• Professional certification applicable to line of business is preferred.

Responsibilities

• Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine exposure and resolution.
• Conducts full investigations and provides reports pertaining to new events, claims and legal actions.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and structures settlements to maximize outcomes.
• Coordinates legal defense by assigning attorneys and reviewing invoices; ensures compliance with client guidelines.
• Uses cost containment techniques and vendor partnerships to reduce total claim costs.
• Identifies fraud, subrogation, recovery, and case-management opportunities to reduce costs.
• Represent the Company in depositions, mediations, and trial monitoring as needed.
• Maintains professional client relationships and accurate claim documentation.

Skills

Analytical skills

Negotiation skills

Customer service

Education

Bachelor's degree

Professional certification as applicable to line of business

Job description

Sedgwick in Arizona seeks a Sr. Claims Specialist, Medical Malpractice, to analyze complex claims, coordinate case management, and control costs while delivering high levels of service.

Ideal candidates have extensive experience in medical malpractice, strong analytical and negotiation skills, and a commitment to timely resolutions and client communication. This role offers growth and the chance to impact outcomes in a respected company.