Claim Advisor - Professional Liability (Cyber)

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® Most Loved Workplace®  Forbes Best-in-State Employer

Claim Advisor, Professional Liability (Cyber)

PRIMARY PURPOSE: To analyze complex or technically difficult Professional Liability claims; to provide resolution of medium to highly complex claims; to perform 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.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Claims Management and Processing:

• Handle a diverse portfolio of Professional Liability claims for various insurance company clients

• Conduct comprehensive investigations

• Analyze policy wordings and determine coverage applicability for each claim

• Draft coverage letter

• Maintain accurate claim files and documentation in compliance with client-specific guidelines and regulatory requirements

• Identify and investigate for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

Client Relations:

• Serve as the primary point of contact for assigned insurance company clients

• Provide regular updates and reports to clients on claim status, trends, and potential high-exposure cases

• Recommend settlement strategies.

• Represent Company in depositions, mediations, and trial monitoring as needed.

Vendor Management:

• Coordinate with and oversee external vendors, including legal counsel

• Manage vendor expenses and ensure adherence to client-specific billing guidelines

• Evaluate vendor performance and make recommendations for the vendor panel

Reporting and Analytics:

• Prepare detailed claim reports and analyses for insurance company

• Calculate and assign timely and appropriate reserves to claims; monitor reserve adequacy throughout claim life.

• Refer cases as appropriate to supervisor and management.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Perform other duties as assigned.

• Support the organization's quality program(s).

QUALIFICATIONS

Education & Licensing Bachelor's degree from an accredited college or university required. JD preferred. Adjuster Licenses as required. Professional certification as applicable to line of business preferred.

Experience At least six (6) years of claims management experience, or equivalent combination of education and experience required.

Skills & Knowledge

• In-depth knowledge of Professional Liability lines, including E&O, D&O, EPL, etc., insurance principles and laws for line-of-business handled, cost containment principles and procedures as applicable to line-of-business

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Excellent negotiation skills

• Good interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

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

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking 

NOTE: Credit security clearance, confirmed via a background credit check, is required for this position. 

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 $120,000- $130,000. 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.

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.