LoRs can be added to your ERAS profile at any time after September 15th, however you cannot assign more than 4 LoRs to each program so if you have already done so, you cannot change it after your submission. But say if you had submitted three LoRs to a certain program then yes you can add the fourth letter at any time later.
That being said the best way to let the programs know about your new LoR is by contacting them directly. Shoot an email to the coordinator and tell her that you recently got a new LoR and you want to add it to your profile.
Also the USCE associated with the new LoR can also be added in your personal statement in case you cannot put it in your ERAS CV (after submission you cannot make changes to your application form) but you can make changes to the personal statement.
You can also take the LoR with you to the interview and show it to them, they'll be impressed by how dedicated and interested you are.
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