• Process and review claims involving minor injuries and routine pay and close cases • Examine claim forms and related documentation to determine coverage • Maintain accurate and up to date claim files, including documentation and reserves • Review and process medical bills and claim related expenses • Issue payments to claimants and providers in accordance with company procedures • Communicate with internal team members and external contacts via email and phone • Handle general inquiries and assist with billing related questions • Refer more complex claims or issues to a supervisor or claims representative • Provide administrative and clerical support to claims examiners and representatives • Help ensure claims are processed efficiently and without unnecessary delays

• Prepare, review, and submit hospital and RHC claims to commercial insurance carriers. • Ensure correct use of CPT, HCPCS, ICD-10, revenue codes, modifiers, and RHC-specific billing requirements. • Verify charges, units, dates of service, provider credentials, and place of service. • Analyze and resolve billing denials, rejections, and underpayments. • Identify root causes of denials (coding, authorization, eligibility, medical necessity, bundling, timely filing, etc.). • Conduct timely follow-up with payers on unpaid, underpaid, or delayed claims. • Communicate with insurance representatives to obtain claim status and resolution. • Ensure compliance with payer guidelines, hospital policies, and RHC billing regulations. • Work closely with coding, registration, authorization, and clinical staff to resolve billing issues.

• Analyzes and processes complex or technically difficult professional liability claims by investigating and gathering information to determine the exposure on the claim • Manages claims through well-developed action plans to an appropriate and timely resolution • Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions • Negotiates claim settlement up to designated authority level • Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life • Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement • Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients • Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost • Represents Company in depositions, mediations, and trial monitoring as needed • Communicates claim activity and processing with the client; maintains professional client relationships • Ensures claim files are properly documented and claims coding is correct • Refers cases as appropriate to supervisor and management • Delegates work and mentors assigned staff

Division or Field Office: Casualty Claims Division Department of Position: Commercial Gen Liability Dept Work from: Remote Salary Range: $79,191.00 - $126,500.00 * 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 (State) based on ERIE's geographical differences, 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: - Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work. - Low contributions to medical and prescription premiums. We currently pay up to 97% of employees’ monthly premium costs. - Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service. - 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension. - Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave. - Career development. Including a tuition reimbursement program for higher education and industry designations. Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. Position Summary Exercises independent discretion in handling complex and/or high exposure commercial liability claims and commercial litigation. - This is a work from home position. - The candidate can work anywhere within Erie's Footprint. - The successful candidate will have the licenses required for KY at the time of hire or within 45 days if external and 60 days if an internal hire. Other state license requirements to be secured as the business need arises. - The successful candidate will handle claims in the SE region, specifically KY and TN. Duties and Responsibilities - Conducts investigations, evaluates and makes recommendations regarding coverage, liability, and resolution strategies. - Handles or assists in handling of litigated claims as directed. Makes recommendations regarding litigation as appropriate. - Responds to complaints and inquiries and resolves issues. - Selects and directs outside experts, and vendors. - Trains and mentors less experienced staff. - Completes required training. The first three 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 evident. Capabilities - Values Diversity - Nimble Learning - Self-Development - Information Management Skills - Collaborates - Customer Focus - Job-Specific Knowledge - Cultivates Innovation - Optimizes Work Processes (IC) - Instills Trust - Ensures Accountability - Decision Quality Qualifications Minimum Educational Requirements - High school diploma or GED required. - Associates or bachelors degree preferred. Additional Experience - Five years' previous claims handling experience or equivalent experience in the legal field required. - Travel for training may be required. Designations and/or Licenses - Completion of Associate in Claims (AIC) program preferred. - Commercial, Property, Casualty, Underwriter (CPCU) designation preferred. - Appropriate license as required by state. - Valid driver's license and good driving record required. Physical Requirements - Use of Personal Protective Equipment (PPE) is required for this role. - Ability to move over 50 lbs using lifting aide equipment; Occasional (<20%) - Climbing/accessing heights; Rarely - Driving; Occasional (<20%) - Lifting/Moving 0-20 lbs; Occasional (<20%) - Lifting/Moving 20-50 lbs; Occasional (<20%) - Manual Keying/Data Entry/inputting information/computer use; Often (20-50%) - Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%)