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Sr. Claims Specialist | Professional Liability | Remote

Work from home Full-time role Hiring

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist | Professional Liability | Remote PRIMARY PURPOSE OF THE ROLE: To analyze complex errors and omissions, directors and officers claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. ARE YOU AN IDEAL CANDIDATE? We are seeking experienced professionals to manage complex errors and omissions and directors and officers claims involving high exposure and significant complexity. Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering effective, cost‑conscious claim resolutions while maintaining strong client relationships. Essential Responsiblities May Include

  • 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.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).

Qualifications

Education & Licensing: Six (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.

TAKING CARE OF YOU

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

Work Environment

Requirements Include – Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $110,000 to $115,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Apply To This Job

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