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

Sedgwick Claims Management Services Ltd; 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

FSA/HSA

Voluntary benefits

Job summary

Sedgwick is seeking a Senior Claims Specialist in Professional Liability to analyze complex errors and omissions, employment practices law, and directors and officers claims. You will coordinate case management, manage total claim costs, and deliver high-quality client service in a remote setting.

The role requires six years of claims management experience, excellent communication, negotiation, and analytical skills, and the ability to mentor staff while maintaining rigorous performance

Qualifications

• Bachelor's degree preferred; six years claims management experience requested.
• Excellent oral and written communication; strong analytical and interpretive skills.
• Strong organizational, negotiation, interpersonal skills; ability to work in a team and meet performance standards.

Responsibilities

• Analyze and process complex professional liability claims; determine exposure and resolve issues.
• Conduct investigations and provide comprehensive reports on events and actions.
• Negotiate settlements up to authorized levels and manage reserves throughout the claim life.
• Coordinate legal defense by engaging attorneys and reviewing invoices; ensure client guidelines are followed.
• Identify cost containment opportunities and potential fraud or recovery cases to reduce total claim costs.
• Mentor assigned staff and contribute to the team's quality program.

Skills

Communication

Analytical skills

Negotiation

Teamwork

Organization

Presentation skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It is 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 | Remote

PRIMARY PURPOSE

To analyze complex or technically difficult errors and omissions, employment practices law, and directors and officers claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

ESSENTIAL FUNCTIONS and 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.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management 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 as appropriate to supervisor and management.
• Delegates work and mentors assigned staff.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.

Six (6) years of claims management experience or equivalent combination of education and experience required.

Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Excellent negotiation skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Physical: Computer keyboarding, travel as required. Auditory/Visual: Hearing, vision and talking.

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

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.

For more, see sedgwick.com