Professional Liability Claims Advisor

🔥 0 minutes ago

🌵 Arizona, California, +4 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🎰 Nevada – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $100k - $145k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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 MedMal and professional liability claims • Resolve highly complex and/or severe 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 • Investigate and process complex or technically difficult claims • Develop action plans to achieve appropriate and timely claim resolution • Conduct or assign full investigations and provide investigation reports • Negotiate claim settlements up to designated authority level • Calculate, assign, and monitor claim reserves • Recommend settlement strategies and bring structured settlement proposals as necessary • Perform coverage analysis and provide opinions and correspondence • Coordinate legal defense, assign attorneys, review attorney invoices, and monitor counsel compliance • Use cost containment techniques and strategic vendor partnerships • Investigate possible fraud, subrogation, contribution, recovery, and case management opportunities • Represent the company in mediations and trial monitoring as needed • Communicate claim activity and processing with clients • Maintain professional client relationships • Ensure claim files are properly documented and coding is correct • Refer cases to supervisors and management as appropriate • Delegate work and mentor others

🎯 Requirements

• High School Diploma or GED required • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • 3-5 years of medical malpractice and professional liability claims management experience required • Availability during Pacific Time Zone business hours • Experience handling complex Medical Malpractice and/or Professional Liability claims • Experience investigating claims and evaluating coverage • Ability to manage high-exposure files • Ability to collaborate with defense counsel • Ability to mentor others • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress and multiple priorities simultaneously • Ability to meet deadlines • Computer keyboarding • Travel as required

🏖️ Benefits

• Professional development opportunities • Flexible work schedule • Referral incentive program • Opportunity to work in an agile environment • Career development and promotional growth opportunities • Medical, dental, and vision benefits on day one • 401K on day one • 401k matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits