Workers Compensation Specialist

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Position Overview

The Workers Compensation Specialist at Erie Insurance plays a vital role within the Claims Division of the organization. This remote position allows the successful candidate to operate from home within ERIE's Footprint, encompassing several states including West Virginia, Virginia, Maryland, and more. The main focus of this role is to handle medical-only workers' compensation claims effectively while exercising independent judgment in decision-making processes.

Responsibilities

In this position, the Workers Compensation Specialist will be responsible for a number of key tasks that are crucial for managing claims efficiently.

• Investigate and determine compensability of claims, ensuring coverage checks are performed appropriately.
• Establish and maintain reserves for claims, and handle all related correspondence and documentation.
• Conduct regular reviews of claim files to ensure compliance and take necessary actions for follow-ups or closures.
• Communicate with policyholders, claimants, and medical providers to establish immediate contact, clarify coverage questions, and resolve issues.
• Process claims-related communications, including medical reports, bills, and investigative reports, determining appropriate actions on claims to be paid or compromised.
• When necessary, refer claims to Workers Compensation Adjuster and prepare for nurse case management.

During the role, specialists will also be responsible for managing vendor activities cost-effectively and participating in training programs to stay updated on legal developments.

Required Skills and Qualifications

Given the complexities involved in handling workers’ compensation claims, candidates must meet certain qualifications.

• A High School diploma or equivalent is mandatory. Higher education could be beneficial but is not explicitly required.
• It is preferable for candidates to have completed relevant courses such as Introduction to Insurance, Introduction to Claims (AIC30), and a course on medical interpretation to handle the specifics of medical claims.
• Candidates need to obtain an adjuster’s license within 90 days of hire if they reside in West Virginia.
• Familiarity with legal guidelines surrounding workers' compensation and the insurance industry is essential, along with strong communication and analytical skills.

Salary and Benefits

The salary range for this role falls between $43,190 and $68,992 per year. The specific salary for the successful candidate will depend on various factors, including the scope of the role, skills, and experiences. This role may also be eligible for an annual bonus payment, adding to the total compensation.

Erie Insurance offers an exceptional benefits package that goes far beyond basic health coverage:

• Comprehensive health, prescription, dental, and vision coverage beginning from the first day of work.
• Low contributions to premiums, as the company contributes up to 97% of the employees’ monthly medical expenses.
• An established pension plan, one of the few among Fortune 500 companies, with full vesting after five years.
• 401(k) plan with a company match of up to 4%.
• Generous paid time off policies including vacation time, sick days, bereavement days, and parental leave.
• Extensive career development opportunities, including tuition reimbursement for further education and training on industry designations.
• Additional perks include company-paid basic life insurance, short and long-term disability insurance, orthodontic coverage for employees and their children, adoption assistance, and community service initiatives.

Working Environment

This is a remote position, which allows for flexibility and autonomy. However, it is important for the candidate to live within ERIE's Footprint for compliance purposes. This includes states such as Ohio, Pennsylvania, Maryland, and others outlined in the job description.

Conclusion

The role of Workers Compensation Specialist at Erie Insurance presents a career opportunity for those interested in insurance and claims management. With a competitive salary, comprehensive benefits, and a supportive work environment, this job appeals to candidates looking for stability and growth in their professional careers. Those who possess the requisite skills and demonstrate their commitment to excellence and service can thrive within this position, making meaningful contributions to the organization and its clients.

This job offer was originally published on himalayas.app