95 applicants

Company

Sedgwick · 9 hours ago

Professional Liability Claims Advisor | Remote (Must Reside in California)

Telecommuter CA

Full-time

Remote

Senior Level

6+ years exp

Maximize your interview chances

BankingInsurance

H1B Sponsor Likely

Security Clearance Required

Insider Connection @Sedgwick

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Analyzes and processes complex or technically difficult medical 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 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 others.

Performs other duties as assigned.

Travels as required.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical malpractice claimsClaims managementMicrosoft Office

Required

Bachelor's degree from an accredited college or university

MEDMAL defense or MedMal claims handling experience

In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled

Claims expertise in medical malpractice

Excellent oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Excellent negotiation skills

Good interpersonal skills

Ability to work in a team environment

Ability to meet or exceed Performance Competencies

Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion

Ability to handle work-related stress

Ability to handle multiple priorities simultaneously

Ability to meet deadlines

Credit security clearance, confirmed via a background credit check

Preferred

Professional certification as applicable to line of business

Six (6) years of medical malpractice claims management experience or equivalent combination of education and experience

Company

Sedgwick

Glassdoor

3.3

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions.

Founded in 1969

Memphis, Tennessee, USA

10001+ employees

http://www.sedgwick.com

H1B Sponsorship

Sedgwick has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (3)

2022 (9)

2021 (14)

2020 (9)