Sedgwick

Senior Claims Specialist, Professional Liability, Medical Malpractice, Long Term Care

Sedgwick

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $110,000 - $120,000 per year

Job Level

Senior

About the role

  • Analyze complex or technically difficult medical malpractice claims.
  • Provide resolution of highly complex nature and/or severe injury claims.
  • Coordinate case management within Company standards.
  • Manage total claim costs while providing high levels of customer service.
  • Investigate and gather information to determine the exposure on the claim.
  • Conduct or assign full investigation and provide report of investigation.
  • Negotiate claim settlement up to designated authority level.
  • Calculate and assign timely and appropriate reserves to claims.
  • Recommends settlement strategies; brings structured settlement proposals as necessary.
  • Coordinates legal defense by assigning attorney and coordinating support for investigation.
  • Monitors counsel for compliance with client guidelines.
  • Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities.

Requirements

  • 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.
  • In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled.
  • 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.
Benefits
  • Medical
  • Dental
  • Vision
  • 401k and matching
  • PTO
  • Disability and life insurance
  • Employee assistance
  • Flexible spending or health savings account
  • Other additional voluntary benefits
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
claims managementmedical malpractice claims analysisnegotiationinvestigationsettlement strategiescase managementfraud investigationreserve calculationreport writingcompliance monitoring
Soft Skills
oral communicationwritten communicationpresentation skillsanalytical skillsorganizational skillsinterpersonal skillsteamworkcustomer serviceproblem-solvingperformance competency
Certifications
professional certificationlicenses