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

Sedgwick; United States; Remote; USD 100,000 - 125,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) with matching

PTO

Disability and life insurance

Employee assistance program

FSAs/HSAs

Job summary

Sedgwick is seeking a Sr. Claims Specialist in the United States to analyze complex professional liability claims and coordinate case management according to client requirements and industry best practices.

The role involves investigating events, negotiating settlements, reserving appropriately, and coordinating defense with attorneys while maintaining strong client relationships. A bachelor's degree and industry licenses are preferred.

Qualifications

• Five years of claims management experience or equivalent.
• Bachelor's degree preferred; licenses as required.

Responsibilities

• Analyze complex professional liability claims and coordinate case management.
• Investigate events, claims and legal actions and prepare reports.
• Negotiate settlements up to designated authority level.
• Set reserves and monitor reserve adequacy throughout the claim life.
• Develop settlement strategies and propose structured settlements as needed.
• Coordinate legal defense and monitor attorney invoices for compliance.
• Represent the company in depositions, mediations, and trial monitoring.
• Communicate claim activity to clients and maintain relationships.
• Ensure proper documentation and claims coding across files.
• Perform other duties as assigned.

Skills

Communication

Presentation

MS Office

Negotiation

Teamwork

Performance standards

Education

Bachelor's degree preferred

Licenses as required

Professional certification 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 RESPONSBILITIES MAY INCLUDE

• 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 include -

• 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. 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.