Medical Management Specialist

Erie Insurance Group

. Handle first-party medical benefit claims, including fatalities and wage-loss claims .

Posted 11/10/2026full-timeAllentown • Pennsylvania • United StatesJuniorMid-Level💰 $50,327 - $80,392 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in handling first-party medical benefit claims, including evaluating coverage decisions, managing cases, and ensuring compliance with applicable state laws. Proficient in medical terminology, claims processing, and vendor management.

Highest-signal resume keywords

Claims Handling ExperienceMedical Terminology ExpertiseKnowledge of State LawsAIC Course CompletionPersonal Injury Protection Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims EvaluationWage-Loss CalculationInvestigation SkillsCase ManagementMedical Bill RepricingData EntryReport PreparationSubrogation IdentificationVendor Activity ControlLegal Compliance

Soft Skills

Communication SkillsOrganizational SkillsAttention to DetailProblem-Solving SkillsTeam Collaboration

Certifications & Qualifications

High School Diploma or GEDBachelor’s DegreeState LicenseCompletion of ERIE Training Program

Industry Keywords

First-Party ClaimsFatalities ClaimsWage-Loss ClaimsNo-Fault LawsCivil LawHuman Anatomy KnowledgeInsurance Department ComplaintsFraud InvestigationRegulatory RequirementsClaims in Litigation

About the role

Key responsibilities & impact

Handle first-party medical benefit claims, including fatalities and wage-loss claims
Evaluate and make coverage decisions
Conduct investigations, determine total claim values, set and maintain adequate reserves, and manage cases
Prepare correspondence and reports
Obtain medical and employment-related records
Calculate wage-loss claims under applicable state laws and bring claims to conclusion
Investigate, evaluate and resolve coverage questions in compliance with applicable state laws
Establish immediate contact with policyholders and claimants; contact agents as necessary
Regularly review claim files and take follow-up or closing action
Evaluate and process claim-related bills, medical reports, rehabilitation reports and special investigative reports
Determine claims to be paid, compromised or contested
Coordinate with the Home Office on serious or massive injury cases
Notify company investigative services of suspected-fraud cases
Manage claims in litigation and assist legal counsel with case strategy when appropriate
Attend industry-related training to stay current on legal developments and regulatory requirements
Assist or act on behalf of the supervisor, including handling insurance-department complaints
Identify subrogation situations and initiate appropriate action
Develop expertise in legal and medical terminology and procedures
Assist in training branch-office personnel
Assign, monitor and control vendor activities cost-effectively

Requirements

What you’ll need

High School Diploma or GED and two years of general claims handling experience required, or Bachelor’s Degree required
Completion of formal ERIE training program required
Experience with personal injury protection
Strong working knowledge of applicable state laws preferred
Good working knowledge of human anatomy and medical terminology preferred
Expertise in state no-fault laws and working knowledge of civil law preferred
Working knowledge of medical bill repricing system preferred
Successful completion of AIC courses preferred
Appropriate license as required by state
Regular and predictable attendance
Ability to perform manual keying, data entry and computer use
Ability to occasionally lift or move 0–20 lbs, 20–50 lbs, and over 50 lbs using lifting-aide equipment
Ability to occasionally push, pull or move wheeled objects or equipment
Ability to rarely drive and access heights

Benefits

Comp & perks

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; Erie currently pays up to 97% of employees’ monthly premium costs
Traditional pension plan; full-time employees are vested after five years of service
401(k) with up to 4% contribution match
Paid vacation, personal days, sick days, bereavement days and parental leave
Tuition reimbursement program for higher education and industry designations
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 community service
Dollar-for-dollar matching of charitable gifts each year
Annual bonus payment may be available