Inside Claims Representative I

Inside Claims Representative I

Under close supervision, handles liability and property claims within designated authority. Resolves coverage and / or liability issues in accordance with applicable state insurance laws, regulations, and procedures. Two Positions Available. The selected candidate will reside within 50 miles of the Raleigh Branch office and will work from home. Weekday evening shifts and / or Saturday shifts will be required based on business and service level needs. The selected candidate will be required to obtain appropriate licensing within 45 days. All Employees that work remotely must have access to internet service bandwidth speeds that meet ERIE's requirement of 50 mbps download and 10 mbps upload.

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

Evaluates and negotiates claims, recognizes subrogation opportunities, and initiates action. Sets up and / or issues payment using ERIE's approved payment methods for settlement; or declines payment within designated authority.

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

Learns and maintains knowledge of liability laws for each state. Learns and maintains knowledge of motor vehicle codes.

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

With supervisor guidance, responds to intercompany arbitration applications. Files contentions and supporting documents on behalf of the insured / driver.

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

Provides support for property claims during periods of heavy volume.

The first five 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. 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 clear.

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

Minimum Educational and Experience Requirements :

High school diploma or GED and two years of related claims handling or customer service experience, or equivalent educational experience required. Bachelor's or Associate's degree preferred.

Designations and / or Licenses :

Successful completion of Introduction to Insurance (INTRO) and Introduction to Claims (AIC 30) preferred. Obtain appropriate licenses as required by state within 45 days of employment in the role for external applicants and 90 days of employment in the role for internal applicants.

Physical Requirements :

Manual Keying / Data Entry / inputting information / computer use; Frequent (50-80%)

Climbing / accessing heights; Rarely

Ability to move over 50 lbs using lifting aide equipment; Rarely

Driving; Never

Lifting / Moving 0-20 lbs; Rarely

Lifting / Moving 20-50 lbs; Rarely

Pushing / Pulling / moving objects, equipment with wheels; Rarely

Nearest Major Market : Raleigh