Senior Medical Malpractice Claims Strategist

Sedgwick; Idaho Falls (ID); On-site; USD 100,000 - 115,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k

PTO

Disability insurance

Life insurance

Employee assistance

FSA/HSA

Job summary

Sedgwick is seeking a Sr. Claims Specialist for Professional Liability (Medical Malpractice) in New Jersey.

You will analyze complex claims, determine exposure, and drive timely, cost‑effective resolutions while maintaining exceptional client service. Ideal candidates bring 6+ years in claims management, a Bachelor's degree, licenses as required, and professional certifications relevant to the line of business.

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 applicable to the line of business preferred.

Responsibilities

• Analyze and process complex medical malpractice claims, gather information, determine exposure, and resolve claims timely.
• Conducts or assigns investigations and provides investigation reports.
• Calculate and assign reserves; monitor reserve adequacy.
• Recommend settlement strategies and structured proposals to maximize settlements.
• Coordinate defense by assigning counsel and reviewing invoices.
• Use cost containment techniques and vendor partnerships to reduce claim costs.
• Identify fraud, subrogation, and recovery opportunities to cut costs.
• Represent the company in depositions and mediations.
• Communicate claim progress with clients and maintain relationships.
• Maintain documentation and proper coding.
• Refer cases to supervisor as needed.
• Perform other duties as assigned.
• Support quality programs.

Skills

Claims management experience

Education

Bachelor's degree

Job description

Sedgwick is seeking a Sr. Claims Specialist for Professional Liability (Medical Malpractice) in New Jersey.

You will analyze complex claims, determine exposure, and drive timely, cost‑effective resolutions while maintaining exceptional client service. Ideal candidates bring 6+ years in claims management, a Bachelor's degree, licenses as required, and professional certifications relevant to the line of business.