Erie Insurance Group · 2 days ago
Workers Compensation Specialist
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Responsibilities
Handles medical only workers’ compensation claims. Investigates and determines compensability, checks coverage, establishes and maintains reserves, handles related correspondence and reports and maintains records. Reviews claim 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 and telephone calls. Determines claims to be paid, compromised.
Refers claim to WC Adjuster when nurse case management appears appropriate and in cases of suspected fraud.
Participates in informal presentations to Agents and Policyholders.
Assigns, monitors and controls activities of vendors in 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.
Qualification
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Required
High School diploma or equivalent
Appropriate license as required by state
Candidates residing in West Virginia are required to obtain an adjuster’s license within 90 days of hire
Preferred
Successful completion of Introduction to Insurance, Introduction to Claims (AIC30) and medical interpretation course
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.
Funding
Current Stage
Public CompanyTotal Funding
unknown1995-10-13IPO
Recent News
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2024-12-05
2024-03-28
2024-01-19
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