[Hiring] Professional Liability Claims Advisor @Sedgwick

Role Description

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? In this role, you will:

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Qualifications

• Education & Licensing: 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.
• Experience: 3-5 years of medical malpractice and professional liability claims management experience required.

Requirements

• Manage and handle MedMal and professional liability claims; provide resolution of highly complex nature and/or severe claims.
• Coordinate case management within company standards, industry best practices and specific client service requirements.
• Manage the total claim costs while providing high levels of customer service.
• Analyze and process complex or technically difficult MedMal and Professional Liability claims.
• Conduct or assign full investigation and provide report of investigation pertaining to new events, claims and legal actions.
• Negotiate claim settlement up to designated authority level.
• Calculate and assign timely and appropriate reserves to claims; monitor reserve adequacy throughout claim life.
• Recommend settlement strategies; bring structured settlement proposals as necessary to maximize settlement.
• Perform coverage analysis and opinion as part of the claim process including all necessary correspondence.
• Coordinate legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices.
• Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for clients.
• Identify and investigate for possible fraud, subrogation, contribution, recovery, and case management opportunities.
• Represent company in mediations and trial monitoring as needed.
• Communicate claim activity and processing with the client; maintain professional client relationships.
• Ensure claim files are properly documented and claims coding is correct.
• Refer cases as appropriate to supervisor and management.
• Delegate work and mentor others.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.