Professional Liability Claims Advisor (Remote) - Medical Malpractice

About the role

Sedgwick is hiring a remote Professional Liability Claims Advisor focused on medical malpractice claims. The role handles complex, high-exposure claims and coordinates their resolution within company standards, industry best practice and client service requirements, while managing total claim costs and maintaining strong client relationships. Availability during Pacific Time Zone business hours is required.

Key responsibilities

• Analyze and investigate complex medical malpractice and professional liability claims to determine exposure, then manage them through action plans to timely resolution.
• Conduct or assign investigations of new events, claims and legal actions and write investigation reports.
• Negotiate settlements up to the designated authority level and recommend settlement strategies, including structured settlement proposals.
• Calculate and monitor claim reserves and perform coverage analysis and opinions.
• Coordinate legal defense by assigning attorneys, supporting investigations and reviewing attorney invoices; monitor counsel against client guidelines.
• Use cost-containment techniques such as strategic vendor partnerships, and look for fraud, subrogation, contribution and recovery opportunities.
• Represent the company in mediations and trial monitoring as needed, and refer cases to supervisors and management when appropriate.
• Communicate claim activity to clients, keep files properly documented and coded correctly, and delegate work and mentor others.

Required profile

• 3-5 years of medical malpractice and professional liability claims management experience.
• Ability to handle complex claims, collaborate with defense counsel and manage high-exposure files in a client-focused way.
• High school diploma or GED required; bachelor's degree preferred, and professional certification preferred.
• Availability during Pacific Time Zone business hours; eligible locations listed in the posting.

What we offer

• Flexible work schedule and referral incentive program.
• Career development and promotional growth opportunities.
• Benefits including medical, dental, vision, 401K on day one, PTO, disability and life insurance, and employee assistance.
• Starting pay range of $100,000 to $145,000 for the jurisdiction named in the posting.