Senior Medical Malpractice Claims Specialist|Prof Liability

Sedgwick; Eagle (ID); On-site; USD 85,000 - 125,000; Full time

Job summary

Sedgwick is seeking a Senior Claims Specialist, Professional Liability (Medical Malpractice) in the United States to analyze complex claims and coordinate resolutions with clients and internal teams.

The ideal candidate will have extensive claims management experience, strong analytical and negotiation skills, and a proven ability to deliver timely, cost‑effective outcomes while maintaining high levels of service.

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 medical malpractice claims to determine exposure and resolve.
• Conducts full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and structured settlement proposals as necessary.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall claim cost.
• Identifies and investigates for fraud, subrogation, contribution, recovery opportunities.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Performs other duties as assigned and supports quality programs.

Skills

Analytical skills

Negotiation skills

Customer service orientation

Judgment and decision-making

Education

Bachelor's degree

Professional certification (as applicable)

Job description

Sedgwick is seeking a Senior Claims Specialist, Professional Liability (Medical Malpractice) in the United States to analyze complex claims and coordinate resolutions with clients and internal teams.

The ideal candidate will have extensive claims management experience, strong analytical and negotiation skills, and a proven ability to deliver timely, cost‑effective outcomes while maintaining high levels of service.