Top 99 Medical adjuster Jobs

Sr. Claims Specialist, Medical Malpractice | Professional Liability
Sedgwick —Alabama
- Full-time
- 6 years
- Customer service
- Analysis skills
Quick Apply
Sr. Claims Specialist, Professional Liability | Medical Malpractice | California
Sedgwick —California
- Full-time
- Remote
- Background check
- Customer service
- 3 years
- Health savings account
- Disability insurance
Quick Apply
Claims & Coding Representative
Harding Shymanski & Company —Evansville, IN
- $15 - $17 an hour
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Medical Only Claims Team Supervisor
CCMSI —Lisle, IL
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- Full-time
- Hybrid work
- Spanish
- 5 years
- Computer literacy
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MEDICAL CLAIMS ADJUSTER
Wilson-McShane Corp —Bloomington, MN
- $28.80 an hour
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- Computer literacy
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Medical Only Claims Team Supervisor
CCMSI —Lisle, IL
- $70,000 - $90,000 a year
- Hybrid work
- Spanish
- 5 years
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- Disability insurance
Medical Only Occupational Accident Claims Adjuster/Work Comp Paralegal or Legal Assistant/Work Comp Adjuster
Transtar Insurance/Bluestar Claims —Phoenix, AZ
- $45,000 - $65,000 a year
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- 2 years
- Paid holidays
- Health insurance
Quick Apply
17h
Medical Biller/Claims Processing - Patient Support Representative (Home-Based)
IQVIA —Atlanta, GA
- $23 an hour
- Full-time
- Remote
- Microsoft Excel
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- HIPAA
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Claims Examiner, Medical Only
AmTrust Financial Services, Inc. —Princeton, NJ
- Full-time
- Mid-level
- Office
- Children
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Medical Bill Adjuster
Encova Insurance —Charleston, WV
- $43,950 - $70,319 a year
- Full-time
- Hybrid work
- Computer literacy
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Workers Compensation Claims Representative | Medical Only Workers Compensation | VA Jurisdiction
Sedgwick —Virginia
- Full-time
- Remote
- Customer service
- Mid-level
- High school diploma or GED
- Health savings account
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7d
Medical Only Adjuster - TPA
Relation Insurance Services —Stuart, FL
- Full-time
- Microsoft Excel
- Mid-level
- High school diploma or GED
- Paid holidays
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Medical Claims Recovery Specialist (Subrogation) - Hybrid - Phoenix, AZ
Gainwell Technologies —Arizona
- $30,500 - $43,500 a year
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Microsoft Access
- Travel reimbursement
- Profit sharing
Medical Claims Specialist (entry level)
Omaha National —Omaha, NE
- Bachelor's degree
- Communication skills
- Entry level
- Paid parental leave
- 401(k)
13d
Medical Claims Adjuster I
GUARANTEE TRUST LIFE INSURANCE GROUP —Elkhorn, NE
- $23.40 - $25.60 an hour
- Full-time
- 1 year
- Communication skills
- Entry level
- Profit sharing
- Health savings account
2d
Claims Representative - Medical Only
Berkshire Hathaway GUARD Insurance Companies —Wilkes-Barre, PA
- Full-time
- Hybrid work
- Customer service
- Mid-level
- Office
- Dental insurance
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PA Workers' Compensation Medical Only Adjuster (Remote)
CCMSI —Pittsburgh, PA
- $45,000 - $55,000 a year
- Full-time
- Spanish
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13d
Claim Representative, Medical Only Senior
CCMSI —Phoenix, AZ
- $50,000 - $65,000 a year
- Full-time
- Hybrid work
- Spanish
- Writing skills
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- Paid holidays
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Medical Only Adjuster (Georgia)
Acrisure, LLC —Summerville, GA
- Customer service
- Computer literacy
- Writing skills
- Continuing education credits
- Commuter assistance
Medical Claims Recovery Specialist (Subrogation) - Tucker, GA - Hybrid
Gainwell Technologies —Tucker, GA
- $43,500 - $48,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Microsoft Access
- Travel reimbursement
- Profit sharing

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Sr. Claims Specialist, Medical Malpractice | Professional Liability

Sedgwick -
Alabama

Quick Apply

Job Details

Full-time

Qualifications

Cost management
Customer relationship building
6 years
Customer service
Caseload management
Claims negotiation
Client relationship development
Compliance monitoring
Malpractice law
Analysis skills
Insurance investigation report preparation
Bachelor's degree
Personal injury dispute resolution
Decision making
Client management
Insurance claims status tracking
Claims documentation management
Senior level
Insurance claims fraud prevention
Insurance claims reserve management
Subrogation claims
Personal injury case experience
Task assignment
Court depositions
Implementing cost-saving initiatives
Legal support investigation
Managing litigation projects

Full 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, Medical Malpractice | Professional Liability

PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult medical malpractice 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 medical malpractice claims involving severe injury and high exposure. Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE:

Analyzes and processes complex or technically difficult medical malpractice 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.
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.
Performs other duties as assigned.
Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing: 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.

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.

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.

Experience:

Medical Malpractice: 3 years (Preferred)
Professional Liability: 3 years (Preferred)

License/Certification:

Adjuster's License (Preferred)

Location:

Alabama (Required)

Work Location: In person

Quick Apply

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