Medical Management Specialist

Erie Insurance Group

. Handle first-party medical benefit claims, including fatalities and wage loss claims, within designated authority and with limited supervision .

Posted 11/6/2026full-timeWarrendale • 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, conducting investigations, and managing cases in compliance with applicable state laws. Proficient in medical terminology and claims processing, with a strong focus on effective communication and collaboration with policyholders and legal counsel.

Highest-signal resume keywords

Claims Handling ExperienceKnowledge Of Applicable State LawsMedical Terminology ExpertiseAIC Course CompletionFormal ERIE Training Program

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims EvaluationInvestigation TechniquesWage Loss CalculationClaims ManagementMedical Bill RepricingSubrogation IdentificationData EntryReport PreparationLegal ComplianceVendor Activity Control

Soft Skills

Effective CommunicationProblem SolvingAttention To DetailTeam CollaborationTraining And Mentoring

Certifications & Qualifications

State LicenseAIC Certification

Industry Keywords

First-Party Medical Benefit ClaimsNo-Fault LawsCivil LawHuman AnatomyClaims LitigationFraud InvestigationInsurance Department ComplianceClaims ProcessingMedical Rehabilitation ReportsEmployment-Related Records

About the role

Key responsibilities & impact

Handle first-party medical benefit claims, including fatalities and wage loss claims, within designated authority and with limited supervision
Evaluate coverage and make claim decisions
Conduct investigations, determine total claim values, set and maintain adequate reserves, and manage cases
Prepare related 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
Review claim files regularly and take follow-up or closing action
Evaluate and process claim-related bills and medical, rehabilitation, 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 regarding suspected fraud
Manage claims in litigation when appropriate and assist legal counsel with case strategy
Attend industry-related training to stay current on legal developments and departmental compliance 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
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 is an essential job function
Manual keying/data entry/computer use often required
Ability to perform occasional lifting/moving of 0–20 lbs and 20–50 lbs
Ability to move over 50 lbs using lifting aide equipment occasionally
Driving rarely required
Pushing/pulling/moving wheeled objects or equipment occasionally
Climbing/accessing heights rarely required

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