Senior Medical Malpractice Claims Strategist

Sedgwick; Lorida (FL); On-site; USD 75,000 - 95,000; Full time

Job summary

Sedgwick is seeking an experienced claims professional to analyze and resolve complex medical malpractice claims with high exposure. You’ll manage investigations, reserves, settlements, and coordination with defense attorneys while delivering strong customer service.

The role requires 6+ years in claims management, a bachelor’s degree, and professional certification as applicable. This on-site position emphasizes quality, efficiency, and cost control in a dynamic environment.

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 or technically difficult medical malpractice claims by investigating and gathering information to determine exposure; manages claims through action plans for timely resolution.
• Conducts or assigns full investigation and provides reports of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; proposes structured settlements to maximize settlement where appropriate.
• Coordinates legal defense by assigning attorneys, coordinating support for investigation, and reviewing attorney invoices.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall claim cost.
• Identifies and investigates fraud, subrogation, contribution, and recovery opportunities to reduce total claim cost.
• 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.

Education

Bachelor's degree from an accredited college or university

Job description

Sedgwick is seeking an experienced claims professional to analyze and resolve complex medical malpractice claims with high exposure. You’ll manage investigations, reserves, settlements, and coordination with defense attorneys while delivering strong customer service.

The role requires 6+ years in claims management, a bachelor’s degree, and professional certification as applicable. This on-site position emphasizes quality, efficiency, and cost control in a dynamic environment.