6 Claims Adjusters jobs in Des Moines

Senior Claims Specialist – Medical Malpractice & Liability

Location: Midwest 
Compensation: $105,000 to $10,000 + Incentive Comp, ESOP, Competitive Benefits

About the Role

Our client is a leading specialty insurance provider known for delivering personalized solutions and exceptional customer service across a broad range of niche programs. As their footprint continues to grow nationwide, they are seeking a Senior Claims Specialist with deep expertise in medical malpractice, general liability, and/or product liability to join their mission-driven and collaborative team.

This is a remote opportunity ideal for a strategic claims professional who thrives on complex file management and values ownership, precision, and impactful client outcomes.

Key Responsibilities

• Manage complex liability claims end-to-end with a focus on accuracy, empathy, and timeliness

• Investigate and evaluate medical professional, DME/product, and general liability losses

• Analyze coverage, assess liability, negotiate settlements, and ensure timely reserving and expense control

• Maintain regulatory compliance and provide clear, consistent communication to internal and external stakeholders

• Collaborate with underwriting, risk, and legal teams to identify trends and implement continuous improvement

Qualifications & Experience

• 5+ years of claims handling experience in general liability (GL), medical malpractice, bodily injury, or product liability

• Proven ability to manage complex claims from initial investigation to final resolution

• Strong understanding of insurance contracts, tort law, medical/legal terminology , and claims best practices

• J.D. is a plus, but not required—strategic thinking and analytical judgment are most important

• Excellent communication, documentation, and negotiation skills

Compensation & Benefits

• Base salary of $1 5,000 to 110,000

• Annual incentive compensation

• Employee Stock Ownership Plan (ESOP)

• Remote work flexibility

• Comprehensive benefits package including medical, dental, vision, 401(k), and more

Salary/Compensation: 105,000 - 110,000 per year

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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 (LTC)
**PRIMARY PURPOSE** : 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.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Analyze 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.
+ 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.
+ 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.
+ Delegates work and mentors assigned staff.
**QUALIFICATION**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
**Experience**
Six (6) years of claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application 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 environmentAbility to meet or exceed Performance Competencies
+ When applicable and appropriate, consideration will be given to reasonable accommodations.
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.
**WORK ENVIRONMENT**
**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_ **_$100,000_** _. 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._
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.**
**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. For more, see** **sedgwick.com**

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
Claims Specialist Sr - Commercial Coverage Specialist
**PRIMARY PURPOSE** **:** 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.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ 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.
+ 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.
+ 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.
+ Delegates work and mentors assigned staff.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.
**Experience**
Six (6) years of claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application 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
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.
_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_ **_($74,228 - $103,000_** **_)_** _. 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.**
**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. For more, see** **sedgwick.com**

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
Senior Claims Specialist, Professional Liability (A&E, D&O)
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Analyzes and processes complex or technically difficult 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.
+ Performs coverage analysis and opinion as part of the claim process including all necessary correspondence.
+ 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.
+ Delegates work and mentors others.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Masters or Juris Doctorate degree from an accredited college or university preferred. Licenses as required. Designations and/or licensing including but not limited to Bachelor of Science in Nursing, Legal Nurse Consultant, Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), Associate in Insurance Claims (AIC), Certified Professional in Health Care Risk Management (CPHRM) preferred.
**Experience**
Ten (10) years of complex claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business
+ Extensive knowledge and comprehension of insurance coverage
+ Claims expertise in medical malpractice, errors and omissions, directors and officers, life sciences, and/or cyber liability
+ 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
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.**
**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. For more, see** **sedgwick.com**

Sr. TPA Specialist, Complex Claims
125068
Zurich Insurance is currently looking for a Sr TPA Specialist. This position will oversee complex Liability claims handled by external TPAs on behalf of Zurich insureds and Captives nationwide. This supervisory oversight position works with minimal direction at high authority levels on assignments reflecting technical complexity. The position requires excellent technical skills as well as product and industry knowledge and is recognized as a technical consultant and advisor both within and outside the company. The Sr TPA Specialist analyzes highly complex coverage situations, evaluates high exposure claims, seeks/grants authority, assigns/explains reserves to senior management and customers, and assists/directs TPA adjusters to resolve claims according to US Best Practices.
The Sr. TPA Specialist regularly communicates with TPAs, customers, brokers, Business Unit Underwriters and representatives, TPA Operations, Claims Legal, Corporate Law, and Senior Management to facilitate and ensure the resolution of a variety of high exposure liability claims including Trucking, Auto, UM/UIM, PIP, Employers Liability, Excess claims, Premises, and Product Liability claims.
The ideal candidate will have a strong background in complex coverage analysis, prior experience in a managerial role, and prior experience in handling trucking claims. Also important is demonstrated organizational and time management skills, proven diary management skills and must be able to document claim files by accurately capturing and updating claims data/information in compliance with best practices. They must also be able to establish timely and accurate reserves and perform ongoing reassessments throughout the claims cycle while providing guidance and leadership to the TPA adjusters.
Basic Qualifications:
+ Bachelors Degree and 8 or more years of experience in the Claims Technical areaOR
+ Juris Doctor and 4 or more years of experience in the Claims and Litigation Management area.OR
+ High School Diploma or Equivalent and 10 or more years of experience in the Claims and/or Litigation Management areaOR
+ Zurich Certified Insurance Apprentice, including an Associate Degree with 8 or more years of experience in the Claims and/or Litigation Management areaAND
+ Must obtain and retain required adjuster licenses
+ Microsoft Office experience
+ Knowledge of insurance regulations, markets, products and coverage
**Preferred Qualifications:**
+ 8 or more years of National GL claims experience including at least 4 years of Large Loss claims and coverage experience in drafting ROR and disclaimer letters on additional insured and contractual indemnity issues
+ AIC, SCLA or CPCU
+ Effective verbal and written communication skills
+ Strong analytical, critical thinking and problem-solving skills
+ Self-starter with ability to oversee work and projects from start to finish with minimal supervision
+ Able to work on multiple projects simultaneously in a fast-paced environment
+ Experience collaborating in a team environment and building cross functional working relationships
+ Able to present information effectively and succinctly to senior leaders, BU and customers
+ Able to direct and control legal actions and expenses, negotiations, and trial strategy on large complex auto and casualty claims in accordance with Zurich Best Practices
+ Ability to direct defense counsel on an ongoing basis to guide the course of complex litigation and settlement strategies
+ Able to analyze coverage issues and interaction between laws of various states, recommend and implement strategies
+ Experience with coverage issues involving analyzing jurisdictional and service of process issues for lawsuits
+ Demonstrated understanding of additional insured and contractual indemnity issues.
+ Ability to analyze and effectively communicate complex coverage determinations to customers/clients/brokers for catastrophic claims
+ Able to explain deductible billing and reinsurance on GL insurance programs and able to explain the difference between SIRs and deductibles
+ Proven ability in coordination of coverage disputes and claims handling with co-defendants and other carriers
+ Ability to determine the scope and exposure for complex claims.
+ Ability to follow reserving process for indemnity and expense in analyzing the exposure of a broad variety of complex claims
+ Able to provide guidance and grant authority on moderate to large exposure GL claims
+ Able to interface with large commercial customers, brokers, and underwriters to ensure good communication flow, risk insight, and trend identification
+ Contribute to profitable growth by providing risk insight, information and trends to BU or customer as needed
+ Experience with claim reviews involving underlying carriers, TPAs, and large customers
+ Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks
+ Serve as technical resource by mentoring lower-level claims professionals and sharing technical knowledge related to specific LOB expertise.
+ Contribute to the team effort by accomplishing related results, providing backup, and participating on projects as needed
+ Good interpersonal skills with ability to motivate others in a team approach to obtain desired results and experience in a work environment that requires collaboration across work groups.
At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please clickhere ( . Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education.The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $98,300.00 - $161,000.00, with short-term incentive bonus eligibility set at 20%.
As an insurance company, Zurich is subject to 18 U.S. Code § 1033.
A future with Zurich. What can go right when you apply at Zurich?
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere ( to learn more.
Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.
Location(s): AM - Illinois Virtual Office, AM - Remote Work (US)
Remote Working: Hybrid
Schedule: Full Time
Employment Sponsorship Offered: No
Linkedin Recruiter Tag: #LI-MD1 #LI-DIRECTOR #LI-REMOTE
EOE Disability / Veterans