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Inside Claims Specialist

Date: Sep 16, 2022

Location: Cary, NC, US, 27518

Company: Erie Insurance

Division or Field Office:

Customer Service Division

Department of Position: Zone Operations Dept 

Work from:

Home (in Erie footprint)

 

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

Investigates and adjudicates complex claims within designated authority. Resolves coverage and/or liability issues in accordance with applicable state laws, regulations and procedures.

 

  • There are two positions available.
  • The successful candidate will be expected to work weekday evenings and/or rotating Saturdays.  
  • The successful candidate may work from anywhere in ERIE's footprint.   
  • The successful candidate will be required to obtain adjusters' licenses in various states.

Duties and Responsibilities

Investigates and adjudicates claims within designated authority, ensuring compliance with appropriate statutory laws. Verifies coverage, establishes and maintains reserves, secures recorded statements, drafts and processes correspondence, reports and records. Documents claim files and facilitates processing of claims in collaboration with other departments. Assigns outside experts when necessary to assist in investigation and in support of potential recovery.

Establishes contact with all parties involved in the claim in accordance with ERIEs expectations.

Investigates and determines applicability of coverage in claims, included, but not limited to ride share claims, repossession claims, low limit property damage and insured non-cooperation issues; or investigates auto theft and fire claims under the personal, commercial and garage auto policies, ensuring compliance with appropriate statutory laws. Interacts with Home Office examination regarding claims that meet conversion criteria.

Evaluates and negotiates claims, recognizes subrogation opportunities and initiates action. Issues checks for settlement or declines payment within designated authority.

Responds to inquiries from Policyholders, Agents, insurance carriers, claimants, ISS, Claims Examination, assigned experts and others.

Obtains additional information as required to determine ERIE's liability.

Duties and Responsibilities (cont'd if applicable)

Secures and maintains licenses as required in order to investigate and adjudicate claims that arise in territories external to ERIEs footprint.

Serves as a mentor and/or trainer for individuals new to the ICR role.

Identifies subrogation opportunities and responds to intercompany-arbitration applications.

Learns and maintains knowledge of no fault/medical management/FPB laws for each state, including recognition of bodily injury claims. Learns and maintains knowledge of liability laws for each state. Learns and maintains knowledge of motor vehicle codes.

Conducts research, attends industry-related training programs and other training sessions to stay current on policy changes, interpretation or new legislation.

This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.

The first six duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished.

Competencies

Self-Development
Collaborates
Cultivates Innovation
Instills Trust
Decision Quality
Values Diversity
Nimble Learning
Customer Focus
Optimizes Work Processes
Ensures Accountability
Detail Orientation
Information Management Skills
Job-Specific Knowledge

Qualifications

Education Equivalents

 

High school diploma or GED and five years of related claims handling or customer service experience required; or


Associate's degree and three years of related claims handling or customer service experience required; or


Bachelor's degree and one year of claims handling experience required.

 

Completion of LOMASelect tests required. Passing score on LOMASelect tests preferred. Successful completion of Associate in Claims (AIC 30) preferred. Ability to obtain appropriate license(s) as requiredby state within 90 days of employment in role.  Position requires incumbents to provide support for property claims during periods of heavy volume.

 

Physical Requirements

Driving; Often (20-50%)
Lifting 0-20 lbs; Occasional (<20%)
Lifting 20-50 lbs; Occasional (<20%)
Lifting Over 50 lbs; Occasional (<20%)
Manual Keying/Data Entry; Often (20-50%)
Pushing/Pulling; Occasional (<20%)


Nearest Major Market: Raleigh