Senior Medical Malpractice Claims Strategist

Sedgwick; Florida; On-site; USD 75,000 - 105,000; Full time

Job summary

Sedgwick in Florida is seeking a Sr. Claims Specialist, Professional Liability (Medical Malpractice) to analyze complex claims and coordinate case management within Company standards and client requirements.

The ideal candidate will demonstrate strong analytical and negotiation skills, handle high-exposure claims, and deliver timely, cost‑effective resolutions while maintaining a high level of customer service.

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 medical malpractice claims by investigating and determining exposure; manages claims toward timely resolution.
• Conducts or assigns full investigation and provides investigation reports for new events, claims and legal actions.
• Calculates and assigns reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies and structured proposals to maximize settlement.
• Coordinates legal defense by assigning attorney and reviewing invoices; monitors counsel for compliance.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall claim costs.
• Identifies fraud, subrogation, contribution, recovery opportunities to reduce total cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and maintains professional client relationships with clients.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases to supervisor and management as appropriate.
• Performs other duties and supports the organization's quality programs.

Skills

Claims management

Education

Bachelor's degree preferred

Job description

Sedgwick in Florida is seeking a Sr. Claims Specialist, Professional Liability (Medical Malpractice) to analyze complex claims and coordinate case management within Company standards and client requirements.

The ideal candidate will demonstrate strong analytical and negotiation skills, handle high-exposure claims, and deliver timely, cost‑effective resolutions while maintaining a high level of customer service.