Erie Insurance Group

2 months ago

Medical Management Specialist (Personal Injury Protection) (Rochester, NY, US, 14692)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 15 hours agoStatus: Live

Job Summary

Handle medical management claims within the Casualty Claims Division for Personal Injury Protection across designated branch offices. Evaluate coverage, conduct investigations, and manage wageLoss calculations. Coordinate with policyholders, claimants, medical providers, and legal counsel; oversee documentation, reserves, and claim closures; contribute to investigations of fraud and support litigation when needed. Ensure compliance with state no-fault laws and company policies.

Location: Pittsburgh

Workplace: Onsite

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Key Responsibilities

•Handle first party medical benefit claims, including fatalities and wage loss claims. Evaluate and make decisions regarding coverage. Conduct investigations, determine total value of claims, set and maintain adequate reserves, and manage cases.
•Prepare related correspondence and reports, obtain medical and employment related records, calculate wage loss claims per applicable state laws and bring claims to conclusion.
•Investigate, evaluate, and resolve coverage questions in compliance with applicable state laws; establish contact with policyholders and claimants and coordinate with agents as necessary.
•Review claim files on a regular basis and take necessary follow-up and/or closing action; evaluate, process and take appropriate action on claim-related bills and related reports.
•Coordinate activities with the Home Office on serious or massive injury cases; notify investigative services of cases involving suspected fraud; manage claims in litigation when appropriate.

Pay and Benefits

Salary: USD 52,843 - 84,410 annually

Key Requirements

•Bachelor's Degree required.
•High School Diploma or GED and two years of general claims handling experience required, or; OR completion of formal ERIE training program, required.
•Appropriate license as required by state.
•Strong working knowledge of applicable state laws preferred.
•Good working knowledge of human anatomy and medical terminology preferred.

Experience:InsuranceClaims

Education:Bachelor's

Skills:CommunicationProblem-solvingAttention to detailTime managementCustomer focus

Languages:English

Company Brief

Erie Insurance Group

Erie Insurance Group is a mutual insurance company providing auto, home, business, and life insurance products through a network of independent agents, serving customers across multiple U.S. states with a focus on local service and claims support.

Industry: Insurance

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Headquarters: Erie, United States

Founded: 1925

Website LinkedIn

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Erie Insurance Group

2 months ago

Medical Management Specialist (Personal Injury Protection) (Rochester, NY, US, 14692)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 15 hours agoStatus: Live

Job Summary

Location: Pittsburgh

Workplace: Onsite

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Key Responsibilities

•Handle first party medical benefit claims, including fatalities and wage loss claims. Evaluate and make decisions regarding coverage. Conduct investigations, determine total value of claims, set and maintain adequate reserves, and manage cases.
•Prepare related correspondence and reports, obtain medical and employment related records, calculate wage loss claims per applicable state laws and bring claims to conclusion.
•Investigate, evaluate, and resolve coverage questions in compliance with applicable state laws; establish contact with policyholders and claimants and coordinate with agents as necessary.
•Review claim files on a regular basis and take necessary follow-up and/or closing action; evaluate, process and take appropriate action on claim-related bills and related reports.
•Coordinate activities with the Home Office on serious or massive injury cases; notify investigative services of cases involving suspected fraud; manage claims in litigation when appropriate.

Pay and Benefits

Salary: USD 52,843 - 84,410 annually

Key Requirements

•Bachelor's Degree required.
•High School Diploma or GED and two years of general claims handling experience required, or; OR completion of formal ERIE training program, required.
•Appropriate license as required by state.
•Strong working knowledge of applicable state laws preferred.
•Good working knowledge of human anatomy and medical terminology preferred.

Experience:InsuranceClaims

Education:Bachelor's

Skills:CommunicationProblem-solvingAttention to detailTime managementCustomer focus

Languages:English

Company Brief

Erie Insurance Group

Industry: Insurance

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Headquarters: Erie, United States

Founded: 1925

Website LinkedIn