Senior Medical Malpractice Claims Strategist

Sedgwick; United States; À distance; USD 90 000 - 130 000; Plein temps

Résumé du poste

Sedgwick is seeking a Sr. Claims Specialist in Medical Malpractice to analyze complex professional liability claims, focusing on severe injuries and high exposure, while coordinating case management and ensuring cost‑effective resolutions.

Ideal candidates bring 6+ years of claims experience, strong analytical and negotiation skills, and the ability to manage investigations, reserves, settlements and client relationships in a fast-paced 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.

Responsabilités

• Analyses and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine exposure; manages claims through action plans to resolution.
• Conducts or assigns full investigation and provides reports of investigations pertaining to new events, claims and legal actions.
• Calculates and assigns timely reserves; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney and coordinating support for investigation; reviews attorney invoices and monitors counsel for client guidelines.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates possible fraud, subrogation, contribution, 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.
• Refers cases to supervisor and management as appropriate.
• Performs other duties as assigned.
• Supports the organization’s quality program(s).

Connaissances

Analytical skills

Negotiation skills

Judgment

Customer service

Claims management

Formation

Bachelor’s degree

Description du poste

Sedgwick is seeking a Sr. Claims Specialist in Medical Malpractice to analyze complex professional liability claims, focusing on severe injuries and high exposure, while coordinating case management and ensuring cost‑effective resolutions.

Ideal candidates bring 6+ years of claims experience, strong analytical and negotiation skills, and the ability to manage investigations, reserves, settlements and client relationships in a fast-paced environment.