Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL)

Sedgwick Claims Management Services Inc.; United States; Remote; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical, dental, vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flexible spending or health savings

Other voluntary benefits

Job summary

Sedgwick Claims Management Services Ltd seeks a Sr. Claims Specialist for Professional Liability (E&O, D&O, EPL). You will analyze complex claims, coordinate case management, and negotiate settlements, while maintaining client relationships and ensuring accurate documentation.

The role involves managing reserves and coordinating defense teams as needed. Qualified candidates have 5+ years in claims management, strong communication and negotiation skills, and a preferred Bachelor's degree.

Qualifications

• 5+ years of claims management experience or equivalent combination of education and experience required.
• Excellent written and oral communication skills; strong presentation skills.
• Bachelor's degree from an accredited college or university preferred; licenses/certifications as applicable.

Responsibilities

• Analyze and process complex or technically difficult professional liability claims and determine exposure.
• Coordinate case management and investigation with client requirements.
• Negotiate settlements up to designated authority level.
• Calculate reserves and monitor reserve adequacy throughout claim life.
• Coordinate defense by assigning attorneys and reviewing invoices; manage vendors to reduce costs.
• Maintain professional client relationships and ensure accurate claim documentation and coding.

Skills

Written and oral communication

Presentation skills

Negotiation skills

Teamwork

Deadline management

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL

Primary Purpose of the role

To analyze complex or technically difficult errors and omissions, employment practices law, and directors and officers claims and coordinate case management within Company standards, industry best practices and specific client service requirements.

Essential Responsibilities

• Analyzes and processes complex or technically difficult professional liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Negotiates claim settlement up to designated authority level.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• 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.
• Performs other duties as assigned.

Qualifications

• Experience: Five (5) years of claims management experience or equivalent combination of education and experience required.
• Skills: written and oral communication skills, presentation skills, PC literate including Microsoft Office Products, strong negotiation skills, ability to work in a team environment, and meet or exceed performance competencies.
• Education: Bachelor's degree from an accredited college or university preferred.
• Licenses as required.
• Professional certification as applicable to line of business preferred.

Work Environment Requirements

• Physical: Computer keyboarding
• Auditory/visual: Hearing, vision and talking
• Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

When applicable and appropriate, consideration will be given to reasonable accommodations.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $100,000 to $125,000.

A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

• medical
• dental
• vision
• 401k and matching
• PTO
• disability and life insurance
• employee assistance
• flexible spending or health savings account
• other additional voluntary benefits

Always accepting applications.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

For more, see sedgwick.com