Senior Specialist - Medical Malpractice Claims

At Sedgwick, we're dedicated to making a meaningful impact in the lives of people around the globe facing unexpected challenges. By becoming a part of our team, you will enjoy a culture that values care, work-life balance, and professional growth. We welcome you to explore a fulfilling career with limitless potential. Recognized by Newsweek as one of America's Greatest Workplaces and certified as a Great Place to Work®, Sedgwick offers a supportive environment where you can excel. PRIMARY PURPOSE: Join us as a Senior Specialist to navigate complex medical malpractice claims, ensuring resolution of severe injury cases while managing total claim costs and providing exceptional customer service. ARE YOU AN IDEAL CANDIDATE? If you thrive in a collaborative atmosphere and are motivated to deliver outstanding results, we want to hear from you! ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Analyze and manage complex medical malpractice claims, employing well-developed action plans to achieve timely resolutions. Conduct investigations for new claims and legal actions, providing comprehensive reports. Negotiate claim settlements within designated authority limits. Timely assess and assign reserves, ensuring adequacy throughout the claim lifecycle. Develop and recommend settlement strategies to maximize outcomes. Coordinate legal defense, monitoring compliance with client guidelines and reviewing attorney invoices. Employ cost containment techniques to minimize overall claim expenses for clients. Investigate potential fraud and explore recovery opportunities. Represent the company in depositions, mediations, and trial monitoring as required. Maintain clear communication regarding claim activity with clients and ensure professional relationships. Accurately document claim files and coding. Delegate responsibilities and mentor junior staff. ADDITIONAL FUNCTIONS AND RESPONSIBILITIES: Perform other assigned duties. Contribute to the organization's quality initiatives. QUALIFICATIONS: Education & Licensing: A bachelor's degree from an accredited institution is preferred. Relevant licenses and professional certifications are a plus. Experience: Six (6) years of experience in claims management or an equivalent combination of education and experience is required. Skills & Knowledge: Expertise in medical malpractice insurance principles and laws, claim duration, and cost containment strategies. Outstanding oral and written communication with strong presentation abilities. Proficiency in PC applications, particularly Microsoft Office. Strong analytical and organizational skills. Excellent negotiation and interpersonal skills. Ability to thrive in a team-based environment. Capacity to meet performance competencies. WORK ENVIRONMENT: We value accessibility and will consider reasonable accommodations when applicable. TAKING CARE OF YOU: We offer a comprehensive benefits package that includes: Three choices for Medical insurance and two Dental plans. Eligibility for tuition reimbursement. A 401K plan with a 50% match on contributions up to the first 6% saved. Four weeks of Paid Time Off (PTO) in your first full year. NEXT STEPS: If selected to move forward, a recruiter will reach out to you. As per regulation, Sedgwick shares a salary range for this position accounting for skills and experience, specifically between $100,000 - $110,000. A full benefits package is also included, covering medical, dental, vision, 401k matching, PTO, disability, life insurance, and additional voluntary benefits. The content of this document is intended to outline the job's general nature and level of responsibilities. It does not provide an exhaustive list of all duties. Management has the discretion to enhance or modify the role as needed. Sedgwick is committed to equal opportunity and promoting a drug-free workplace. If you're interested in this position but your qualifications don't perfectly match all criteria, we encourage you to apply regardless. Sedgwick values diversity and inclusion, recognizing that unique skills and experiences are assets to our workforce. Sedgwick stands as the forefront partner in risk and claims administration, committed to aiding clients in navigating unforeseen challenges. Our extensive expertise and advanced technology set the standard in claims services, providing exceptional solutions in a dynamic risk environment.

Created: 2026-03-04