Claims Processor - Administration

Fortune Best Workplaces in Financial Services & Insurance

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.

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.

brings structured settlement proposals as necessary to maximize settlement.

Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; 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; Ensures claim files are properly documented and claims coding is correct.

Experience: Six (6) 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

Bachelor's degree from an accredited college or university preferred. Computer keyboarding

Auditory/visual: 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.