Workers' Compensation Adjuster II
Erie Insurance Group
Date: 1 week ago
City: Erie, PA
Salary:
$67,958
-
$108,556
per year
Contract type: Full time
Division Or Field Office
Claims Division
Department of Position: Workers' Compensation Dept
Work From
Home in ERIE's Footprint
Salary Range
$67,958.00 - $108,556.00 *
salary range is for this level and may vary based on actual level of role hired for
Benefits That Go Beyond The Basics
We strive to be Above all in Service to our customers—and to our employees. That’s why Erie Insurance offers you an exceptional benefits package, including:
Position Summary
Responsible for handling Worker's Compensation claims within designated authority, exercising discretion and independent judgement in the decision-making process on all claims assigned.
Self-Development
Detail Orientation
Collaborates
Cultivates Innovation
Instills Trust
Information Management Skills
Decision Quality
Values Diversity
Job-Specific Knowledge
Nimble Learning
Customer Focus
Optimizes Work Processes
Ensures Accountability
Qualifications
Minimum Educational Requirements
Lifting/Moving 0-20 lbs; Occasional (<20%)
Lifting/Moving 20-50 lbs; Occasional (<20%)
Ability to move over 50 lbs using lifting aide equipment; Occasional (<20%)
Driving; Rarely
Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%)
Manual Keying/Data Entry/inputting information/computer use; Often (20-50%)
Climbing/accessing heights; Rarely
Claims Division
Department of Position: Workers' Compensation Dept
Work From
Home in ERIE's Footprint
Salary Range
$67,958.00 - $108,556.00 *
salary range is for this level and may vary based on actual level of role hired for
- This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment.
Benefits That Go Beyond The Basics
We strive to be Above all in Service to our customers—and to our employees. That’s why Erie Insurance offers you an exceptional benefits package, including:
- 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.
Position Summary
Responsible for handling Worker's Compensation claims within designated authority, exercising discretion and independent judgement in the decision-making process on all claims assigned.
- Successful candidate ideally will live in PA but can reside anywhere in ERIE’s Footprint.
- PA Adjuster experience is strongly preferred.
- Will also consider Workers' Compensation Adjuster I.
- 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.
Self-Development
Detail Orientation
Collaborates
Cultivates Innovation
Instills Trust
Information Management Skills
Decision Quality
Values Diversity
Job-Specific Knowledge
Nimble Learning
Customer Focus
Optimizes Work Processes
Ensures Accountability
Qualifications
Minimum Educational Requirements
- High School diploma or GED required.
- Bachelor’s degree preferred.
- 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.
- Successful completion of AIC37, AIC44 and medical interpretation courses preferred.
- Willingness to obtain and maintain any required licenses.
- Valid driver’s license required.
Lifting/Moving 0-20 lbs; Occasional (<20%)
Lifting/Moving 20-50 lbs; Occasional (<20%)
Ability to move over 50 lbs using lifting aide equipment; Occasional (<20%)
Driving; Rarely
Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%)
Manual Keying/Data Entry/inputting information/computer use; Often (20-50%)
Climbing/accessing heights; Rarely
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