Erie Insurance Group · 5 hours ago
Workers' Compensation Adjuster II
Silver Spring, MD
Full-time
Remote
Mid, Senior Level
$68K/yr - $109K/yr
5+ years exp
Maximize your interview chancesProperty Insurance
Insider Connection @Erie Insurance Group
Get 3x more responses when you reach out via email instead of LinkedIn.
Responsibilities
Handles workers’ compensation claims, including fatalities and possible complex claims. Investigates and determines compensability and evaluates and makes recommendations regarding coverage of claims. Conducts field investigations as necessary, determines total value of claims, including anticipated time off and settlement exposure, establishes and maintains adequate reserves, manages cases and prepares related correspondence and reports. Maintains all records and related materials. Reviews claims files on a regular basis and takes necessary follow-up and/or closing action.
Establishes immediate contact with policyholders, claimants and medical providers. Contacts agents as necessary.
Evaluates and resolves coverage questions, exercising discretion and independent judgement and in compliance with applicable workers compensation law.
Receives, processes and takes appropriate action on claim-related communications, including bills, medical reports, specialist investigative reports, telephone calls and legal documents in litigated claims. Determines claims to be paid, compromised or contested.
Coordinates activities with rehabilitation specialist on seriously injured claimants and refers special risk situations to commercial underwriting. Notifies company investigative services of cases involving suspected fraud.
Negotiates settlements with petitioner's counsel, referring to defense counsel when appropriate. Works in partnership with defense counsel in formulating plan of action in litigated claims. Attends hearings and mediations as required.
Participates in informal presentations to Agents and Policyholders.
Assigns, monitors, and controls activities of vendors in a cost-effective manner.
Attends industry-related training programs to stay current on legal developments and ensure compliance with applicable laws and regulations impacting the operation of the department.
Assists or acts on behalf of the Worker's Compensation Claims Supervisor when required.
Qualification
Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.
Required
High School diploma or GED required.
Five years of previous workers’ compensation claims handling experience, including a strong working knowledge of applicable state laws required.
Strong working knowledge of medical bill processing required.
Valid driver’s license required.
Preferred
Bachelor’s degree preferred.
Successful completion of AIC37, AIC44 and medical interpretation courses preferred.
Willingness to obtain and maintain any required licenses.
Benefits
Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work.
Low contributions to medical and prescription premiums. We currently pay up to 97% of employees’ monthly premium costs.
Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service.
401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension.
Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave.
Career development. Including a tuition reimbursement program for higher education and industry designations.
Company-paid basic life insurance
Short-and long-term disability insurance
Orthodontic coverage for children and adults
Adoption assistance
Fertility and infertility coverage
Well-being programs
Paid volunteer hours for service to your community
Dollar-for-dollar matching of your charitable gifts each year.
Company
Erie Insurance Group
Erie Insurance offers a range of services to meet family insurance needs, including a variety of home and tenant (renters) insurance policy.
5,001-10,000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1995-10-13IPO· undefined
Leadership Team
Ron Habursky
SVP & Chief Investment Officer
Timothy Shine
Senior Vice President, IT
Recent News
2024-03-28
2024-01-19
2023-11-08
Company data provided by crunchbase
