Senior Claims Specialist, Professional Liability, E&O, D&O, EPL
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Job Description
Analyzing complex professional liability claims in a remote role at Sedgwick. Managing claims with a focus on customer service and compliance to company standards.
Responsibilities:
- Analyzes and processes complex or technically difficult professional liability claims by investigating and gathering information to determine the exposure on the claim
- Manages claims through well-developed action plans to an appropriate and timely resolution
- Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions
- Negotiates claim settlement up to designated authority level
- Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life
- Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement
- Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients
- Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost
- Represents Company in depositions, mediations, and trial monitoring as needed
- Communicates claim activity and processing with the client; maintains professional client relationships
- Ensures claim files are properly documented and claims coding is correct
- Refers cases as appropriate to supervisor and management
- Delegates work and mentors assigned staff
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
Benefits:
- medical
- dental
- vision
- 401k and matching
- PTO
- disability and life insurance
- employee assistance
- flexible spending or health savings account
- other additional voluntary benefits
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