• Coding/Program Management • Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc) • Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues • Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways • Advises the executive team on best practices for drug purchase opportunities • Quality and Performance Improvement • Conducts high level audits for coding • Assists Management with evaluation of processes • Conducts and organizes provider peer reviews, physician queries • Analysis and Collaboration • Proactively researches and understands payer issues • Troubleshoots and resolves issues that impact revenue • Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management

Division or Field Office: Casualty Claims Division Department of Position: Claims Department Work from: Remote in Maryland or DC Salary Range: $56,367.00 - $90,040.00 * 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 and judgement in claims handling involving complex liability issues, to include coverage issues and minor injury claims. - Candidate will primarily handle claims for MD and DC but could handle claims for other jurisdictions. - Preferred candidate will work remote and can live near MD or DC however, hiring manager will consider candidates that live in Northern VA and/or West Virginia or within surrounding areas. Duties and Responsibilities - Conducts investigations, evaluate and make recommendations regarding coverage and liability. - Sets and maintains reserves. Obtains documents to establish the value of claims and negotiates settlement or declines claim. - Documents files and submits final report. - Identifies subrogation opportunities and initiates appropriate action. - Negotiates with all parties, or their representatives, within designated authority. - Completes required training. - Trains and mentors. - Travel for training may be required. 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 evident. Capabilities - Values Diversity - Nimble Learning - Self-Development - Collaborates - Customer Focus - Cultivates Innovation - Information Management Skills - Instills Trust - Optimizes Work Processes (IC) - Job-Specific Knowledge - Ensures Accountability - Decision Quality Qualifications Minimum Educational and Experience Requirements - High school diploma or equivalent and two years of claims or customer service experience, preferably with casualty claims, required. - Equivalent educational experience will be considered. - Associate's or Bachelor's degree, preferred. Designations and/or Licenses - Appropriate license as required by state. 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%) - Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%) - Climbing/accessing heights; Rarely - Driving; Occasional (<20%) - Manual Keying/Data Entry/inputting information/computer use; Frequent (50-80%)

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Alternative Markets specialized in mono-line and/or multi-line primary programs on either a traditional guaranteed cost (Specialty Programs) or risk-sharing basis (Agency, Association or Group Captives). Alternative Markets focuses on niche programs. https://www.greatamericaninsurancegroup.com/about-us/business-operations/division/alternative-markets Alternative Markets is looking for a Senior Claims Specialist/Claims Technical Director to join their team. Ideally we are looking for candidates who can work out of our downtown Cincinnati office but we are also open to remote candidates. Job title and salary will be dependent upon successful applicant's level of experience. Essential Job Functions and Responsibilities - Investigates and maintains claims: - Reviews and evaluates coverage and/or liability to include tenders. - Secures and analyzes necessary information (i.e., reports, policies, contracts, releases, statements, or other documents) in the investigation of claims. - Works toward the resolution of claims files, and attends arbitrations, mediations, depositions, or trials as necessary. - Establish reserves and negation settlements within prescribed limits. Submit recommendations to supervisor when they exceed personal authority. - Conveys more complex information (coverage, decisions, outcomes, negotiations, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. - Ensures that claims payments are issued in a timely and accurate manner. - Ensures that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. - Provides technical advice to lower level positions and other functional areas. - May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports. - Performs other duties as assigned. Job Requirements - Education: Bachelor’s Degree or equivalent experience. - Field of Study: Liberal Arts, Business or a related discipline. - Experience: Generally, 10 or more years of related experience. New York Labor claims experience strongly preferred. Business Unit: Alternative Markets Salary Range: $100,000.00 -$135,000.00 Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers. *Excludes seasonal employees and interns.

**Open to remote** Series 6 FINRA License - REQUIRED About the job: The Life Claims & Annuity Sr. Specialist is responsible for assessing and making decisions on variable/portfolio death claims, death under income plan, variable/fixed annuity, and Northwestern Access Fund accounts. This role involves partnering with the contestable team on variable contestable claims. Ensuring compliance with a $2M signature authority limit involves analyzing various documents such as death certificates, claim forms, and legal documentation. Additionally, the specialist conducts routine reviews of claims by contract language and state laws. What You’ll Do: Decision Making and Claims Review - Make fair, accurate, and timely decisions on variable/portfolio death claims, death under Income plans, variable/fixed annuities, and Northwestern Mutual Access Fund accounts. Maintaining compliance with a $2M signature authority limit. - Examine claim information obtained, including beneficiary data, policy values, policy status, and analyze information received during the claim review process, such as death certificates, claim forms, assignment forms, divorce decrees, and estate and trust documentation. - Research and evaluate solutions to arising situations and resolve concerns as needed. Deviate from procedures to handle unique situations effectively. - Exhibit empathy, professionalism, and tact in all interactions, especially when handling sensitive or contentious claims. - Provide exceptional customer service to policyholders, beneficiaries, and financial advisers, addressing their questions and concerns throughout the claims process. - Communicate claims decisions to beneficiaries and other parties clearly and sensitively, providing detailed explanations and supporting documentation as needed. - Manage phone and transactional responsibilities while demonstrating a strong commitment to confidentiality. - Maintain organization, accuracy, and timeliness in individual case management systems; capture and document claim-related information accurately and/or refer tasks as appropriate. - Maintain production and claim quality standards to ensure efficiency and accuracy. Continuous Improvement and Innovation - Participate in continuous improvement initiatives to enhance claims handling processes, reduce turnaround times, and improve accuracy. - Assist with special projects and initiatives as needed to support the business. - Embrace new technology and serve as an advocate by educating beneficiaries and field representatives. - Support digital savvy capabilities in self and others and adapt to changing environments and new situations effectively and positively. What You’ll Bring to the Role: - Bachelor’s degree or an equivalent combination of education and progressively responsible work experience. - A Series 6 FINRA License is required. - Previous experience in claims, income plan, or annuity preferred. - High degree of accuracy in handling detailed technical work. - Self-motivated with proven responsibility for work results and group goals. - Technically savvy with the ability to toggle between multiple applications and computer monitors simultaneously. - Strong organizational skills, able to independently prioritize to meet deadlines. - Exhibits empathy and strong client focus, with excellent customer service skills. - Excellent communication skills (both verbal and written) to include the proven ability to negotiate. - Leadership and decision-making skills, to include the abilities to evaluate/identify, diagnose, and implement decisions/solutions to questions/problems within the scope of the job. - Ability to analyze complex information and ask thoughtful questions. Skills You have: - Adaptive Communication: Formulates strategies to be used to convey complex information about services, products, systems, or processes to targeted audiences; communicates and liaises between technical and non-technical audiences. - Analytical Thinking: Organizes and compares various aspects of a situation to comprehend and identify key or underlying complex issues through the use of quantitative data and analysis; leverages strong business acumen, problem solving, and interpersonal skills to think critically about situations from multiple perspectives and consistently seeks ways to improve processes. - Annuity Acumen: Demonstrates a thorough understanding of the underlying financial principles and risks associated with annuity products. Accurately identifies potential fraud or misrepresentation in annuity applications. - Attention to Detail: Focuses on specific details to spot and correct errors in advance of them being found and surpass quality expectations. Performs work with thorough proofreading for presentation, content, accuracy, and overall quality. - Claims Acumen: Applies the knowledge of claims philosophy, contracts, and policies and procedures for filing claims, assessing claims for accuracy and completeness, verifying eligibility, and adjudicating claims based on established criteria to handle complex, contestable, sensitive, and large benefit amount claims. Evaluates medical, financial, and occupational information and reviews to determine if insured meets contractual provisions while taking the state regulations or other relevant contractual information into consideration to make informed decisions. Analyzes insurance claims to determine the validity/risk of the claim, and the extent of coverage. - Customer Centricity: Applies a customer first mindset to design and continuously improve solutions, systems, processes, and services that support enterprise strategy, impact critical business outcomes, and drive organizational success. - Empathetic Communication: Empathizes and relates to clients navigating difficult life situations. Handles cases with care and compassion. Practices active listening to understand the unique needs of the customer and take more informed decisions about their policies. #LI-Remote This position has been classified as a Registered Representative under NMIS guidelines and requires fingerprinting. Compensation Range: Pay Range - Start: $57,260.00 Pay Range - End: $106,340.00 Geographic Specific Pay Structure: Structure 110: $63,000.00 USD - $117,000.00 USD Structure 115: $65,870.00 USD - $122,330.00 USD We believe in fairness and transparency. It’s why we share the salary range for most of our roles. However, final salaries are based on a number of factors, including the skills and experience of the candidate; the current market; location of the candidate; and other factors uncovered in the hiring process. The standard pay structure is listed but if you’re living in California, New York City or other eligible location, geographic specific pay structures, compensation and benefits could be applicable, click here to learn more. Job Posting End Date: 04/30/2026 The timeline for this job posting may be shortened or extended based on organizational needs. Grow your career with a best-in-class company that puts our clients' interests at the center of all we do. Get started now! Northwestern Mutual is an equal opportunity employer who welcomes and encourages diversity in the workforce. We are committed to creating and maintaining an environment in which each employee can contribute creative ideas, seek challenges, assume leadership and continue to focus on meeting and exceeding business and personal objectives.