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Compensation Adjuster
Erie Indemnity Company
Rochester, NY, United States
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Division or Field Office:
Claims Division
Department of Position:
Workers' Compensation Dept
Work from:
At Erie Insurance, you’re not just part of a Fortune 500 company; you’re also a valued member of a diverse and inclusive team that includes more than 5,000 employees and over 2,200 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. To attract and retain the best talent, we reward our team members with competitive salaries and a very generous benefits package.
Position Summary
Within designated authority, handles workers' compensation claims, exercising discretion and independent judgment in the decision-making process.
Duties and Responsibilities
Establishes immediate contact with Policyholders, claimants and medical providers. Contacts Agents as necessary.
Handles workers' compensation claims. Investigates compensability, evaluates and makes recommendations regarding coverage of claims. Conducts investigations, determines total value of claim, sets and maintains adequate reserves, manages cases and prepares related correspondence and reports. Maintains related records.
Assigns, monitors and controls activities of vendors in a cost-effective manner.
Evaluates and resolves coverage questions, exercising discretion and independent judgment, and in compliance with applicable workers' compensation law.
Evaluates, processes and takes appropriate action on claim-related bills and medical, rehabilitation and special investigative reports. Determines claims to be paid, compromised or contested.
Reviews claim files on a regular basis and takes necessary follow-up and/or closing action.
Coordinates activities with a rehabilitation specialist on seriously injured claimants and refers special risk situations to commercial underwriting. Notifies company investigative services of cases involving suspected fraud.
Competencies
Ability To Learn And Follow Procedures
Ability to Manage Complexity
Decision Making
Detail Orientation
Developing And Maintaining Relationships
Influencing Skills
Information Management Skills
Interpersonal Communication
Job-Specific Knowledge
Planning And Organizing
Problem Analysis
Service Orientation
Time Management
Qualifications
High school diploma or GED required. Bachelor's degree preferred. Three years of previous claims handling experience required. Previous experience in worker's compensation preferred. In lieu of this, a bachelor's degree in any field required. Familiarity with medical bill processing system preferred. Pursuit of AIC 37, AIC 44 and medical interpretation courses preferred. Willingness to obtain and maintain any required licenses. Valid driver's license required.