Senior Claims Specialist, Medical Malpractice – Professional Liability

🔥 1 minute ago

🏈 Alabama – Remote

🏈 Alabama – Remote

⏰ Full Time

🟠 Senior

📋 Claims Specialist

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This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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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

• Analyze complex or technically difficult medical malpractice claims • Provide resolution for 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 • Investigate and gather information to determine claim exposure • Manage claims through action plans to timely resolution • Conduct or assign investigations and report on new events, claims, and legal actions • Calculate, assign, and monitor claim reserves • Recommend settlement strategies and develop structured settlement proposals • Coordinate legal defense, assign attorneys, review attorney invoices, and monitor counsel compliance • Use cost containment techniques and strategic vendor partnerships • 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 and maintain professional client relationships • Ensure claim files are documented and coding is correct • Refer cases to supervisors and management as appropriate • Support the organization's quality programs • Perform other duties as assigned

🎯 Requirements

• 6 years of claims management experience or equivalent combination of education and experience required • Bachelor's degree from an accredited college or university preferred • Licenses as required • Professional certification as applicable to line of business preferred • Strong analytical and negotiation skills • Sound judgment and discretion • Ability to deliver timely, cost-effective claim resolutions • Ability to maintain a high level of customer service • Clear and conceptual thinking ability • Ability to meet deadlines • Computer keyboarding • Hearing, vision and talking

🏖️ Benefits

• Work-life balance • Caring culture • Professional development and career growth opportunities • Equal Opportunity Employer • Drug-Free Workplace

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