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Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL)

Role overview

Summary

This role focuses on analyzing and managing complex professional liability claims at Sedgwick. You will coordinate case management according to company standards and client service requirements, ensuring effective communication and resolution of claims.

Qualifications

  • Five (5) years of claims management experience or equivalent combination of education and experience required.
  • Written and oral communication skills, presentation skills, and strong negotiation skills.
  • PC literate including Microsoft Office Products.
  • Preferred: Bachelor's degree from an accredited college or university
  • Preferred: Professional certification as applicable to line of business

Responsibilities

  • Analyze and process complex professional liability claims by investigating and gathering information.
  • Conduct or assign full investigations and provide reports on new events and claims.
  • Negotiate claim settlements up to designated authority level.
  • Coordinate legal defense by assigning attorneys and monitoring compliance with client guidelines.

About the company

Sedgwick logo

Sedgwick

  • Insurance
  • Large
  • 10,001+
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. The company provides a broad range of resources tailored to our clients’ specific needs in casualty, property, marine, benefits, brand protection and other lines. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 31,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Join us! Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Top 100 Most Loved Workplace® Forbes Best-in-State Employer

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Job description

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 | E&O, D&O, EPL)

PRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult errors and omissions, employment practices law, and directors and officers claims and coordinate case management within Company standards, industry best practices and specific client service requirements.


ESSENTIAL RESPONSBILITIES MAY INCLUDE

  • 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.
  • 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.
  • Performs other duties as assigned.

QUALIFICATIONS

Experience: Five (5) years of claims management experience or equivalent combination of education and experience required.

Skills: written and oral communication skills, presentation skills, PC literate including Microsoft Office Products, strong negotiation skills, ability to work in a team environment, and meet or exceed performance competencies

Education: Bachelor's degree from an accredited college or university preferred. Licenses as required. 

  • Professional certification as applicable to line of business preferred.

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.

When applicable and appropriate, consideration will be given to reasonable accommodations.

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 $100,000 to $125,000. 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. Always accepting applications.


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.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

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.

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