Claims Advisor, Professional Liability – E&O, D&O

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $115k - $130k / year

⏰ Full Time

🟠 Senior

🔴 Lead

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Manage and handle executive, errors and omissions, and complex professional liability claims • Resolve highly complex and/or severe injury claims • Coordinate case management within company standards, industry best practices, and client service requirements • Manage total claim costs while providing high levels of customer service • Analyze and process complex or technically difficult liability claims by investigating claim exposure • Conduct or assign full investigations and provide investigation reports for new events, claims, and legal actions • Negotiate claim settlements up to designated authority level • Calculate and assign timely and appropriate claim reserves • Recommend settlement strategies • Perform coverage analysis and opinions • Coordinate legal defense by assigning attorneys, supporting investigations, reviewing attorney invoices, and monitoring counsel compliance with client guidelines • Use cost containment techniques and strategic vendor partnerships to reduce claim costs • Identify and investigate fraud, subrogation, contribution, recovery, and case management opportunities • Represent the company in depositions, mediations, and trial monitoring as needed • Communicate claim activity and processing with clients • Ensure claim files are properly documented and claim coding is correct • Refer cases to supervisors and management as appropriate

🎯 Requirements

• Ten (10) years of complex claims management experience, or equivalent combination of education and experience • Master’s or Juris Doctorate degree from an accredited college or university preferred • Licenses as required • Preferred designations and/or licensing include Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), and Certified Professional in Health Care Risk Management (CPHRM) • In-depth knowledge of medical malpractice insurance principles and applicable laws • Knowledge of recoveries, offsets and deductions, claim and disability duration, and cost containment principles • Extensive knowledge and comprehension of insurance coverage • Claims expertise in errors and omissions and directors and officers insurance • Excellent oral and written communication, including presentation skills • PC literacy, including Microsoft Office products • Analytical and interpretive skills • Excellent negotiation skills • Ability to work in a team environment • Ability to meet or exceed performance competencies • Ability to perform computer keyboarding • Hearing, vision, and talking capabilities • Clear and conceptual thinking ability, excellent judgment and discretion, and ability to meet deadlines

🏖️ Benefits

• Medical, dental, and vision insurance • 401k and matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Work-life balance • Caring culture