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Workers' Compensation Adjuster II - Charlotte, United States - Erie Insurance
Description
Division or Field Office:Claims Division
Department of Position: Corporate Claims Department
Work from:
Within Erie's Footprint- Remote Salary Range:
$67, $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.
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 6,000 employees and over 13,000 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.
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 North Carolina, exercising discretion and independent judgement in the decision-making process on all claims assigned.
North Carolina adjuster experience is strongly preferred.
Must be willing to obtain North Carolina adjuster license within 60 days.
Will also consider Workers' Compensation Adjuster I.
Duties and 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.
Competencies
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
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.
Physical 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
