Social Insurance Specialist (Claims Specialist)
3.
5 Charleston, WV Charleston, WV Full-time Full-time $40,918 - $75,013 a year $40,918 - $75,013 a year 7 days ago 7 days ago 7 days ago This keystone position of the Social Security Administration authorizes entitlements to programs administered by the agency.
The incumbent reviews and authorizes claims and other complex determinations for benefits under Titles II, XVI and/or XVIII of the Social Security Act.
Performs duties involved in one or more of the following:
Title II, Title XVI, XVIII, a generalist in Title II, XVI, and VXIII, a field representative, The incumbent will perform the duties below as it relates to his or her assigned area.
Adjudicates and authorizes entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA.
Develops, investigates, and resolves claims and post-entitlement actions that may involve suspension, resumption, adjustment, or termination of eligibility, or payments.
Conducts inquiries and/or interviews to obtain, clarify, and verify information about individual applicants' initial and continuing eligibility for programs administered by SSA.
Assists the public by explaining the options for conducting business with SSA, including online services.
Informs claimants and/or their representatives about their legal rights and reporting responsibilities.
Examines evidence to evaluate its validity and acceptability in establishing entitlement to benefits, and, when necessary, takes the required developmental actions to obtain all available relevant evidence.
Assists the applicant in securing evidence, electronically records the evidence required, and when applicable, prepares and records special determinations of fact.
Completes development and evaluation of all facts and evidence.
Determines issues in any claim or referred post-adjudicative action, prepares formal or informal determinations relating the facts, evidence and issues to the requirements of the law, regulations, policies and precedents.
Takes related actions to update or establish SSA records.
Responds to contacts from beneficiaries, recipients, the public or other SSA staff by researching inquiries or initiating action to make changes to the claims or beneficiary record.
Develops facts through direct, mail, electronic, or telephone contacts with FOs, PSCs, WSCs/WSUs, FSPs, beneficiaries, or third parties to resolve discrepancies and to obtain complete information.
Performs representational and information activities to secure cooperation of the public; to disseminate facts and advise on program coverage; and to enlist the understanding and cooperation of local organizations.
Provides technical guidance and mentoring (informal and formal) to other employees.
Analyzes and prepares detailed reports of trainee's progress to management, orally or through the appropriate system.
Participates in training sessions both as a student and/or as an instructor, as required.
Protects the rights of individuals by assuring claimants and/or their personal representative understand the claimant's legal rights and obligations under the Act and its relationship to other social welfare and benefit programs.
Assists individuals in filing administrative appeals in the programs administered.
Protects the integrity of SSA programs through identification, investigation, and resolution of potential program abuse/fraud.
When appropriate, determines the need for and makes referrals to the appropriate component.
Properly safeguards personally identifiable information (PII) from loss, theft, or improper disclosure, including inadvertent disclosure, and immediately notifies management of any breach, loss, or potential loss of PII in any form.
Works as an integral part of the unit, office, module, component, team or center, taking all actions necessary to improve overall processing time and quality.
Performs special projects and duties required to achieve the immediate organization's goals.
Participates in studies, projects, etc.
initiated by the unit, module, component, section, office, program service center, area, or SSA Headquarters; analyzes data and prepares reports of study results as required.
Performs other duties as assigned and assumes new responsibilities mandated by legislative or policy changes.
REQUIREMENTS & QUALIFICATIONS U.
S.
Citizenship required Selective Service Registration, if applicable (www.
sss.
gov) Fingerprinting and background and/or security investigation may be required Job offers are contingent on fingerprinting and background / security investigation results Selectees may be required to serve a 1 or 2 year probationary period Relocation expenses will not be paid All qualification requirements must be met by the closing date of the announcement Must pass Competency Assessment Interview Process (CAIP) interview.
Selectees are required to complete a 11-13 week technical training class.
SALARY & ADVANCEMENT Entry into these positions is at the GS-5 and GS-7 level with career ladder advancement opportunity within the position to the GS-11 level.
Salaries are competitive and include locality adjustments based on the job location.
SSA offers promotion opportunities and a wide variety of positions in our numerous offices across the country.
GREAT
Benefits:
Earn 13 paid vacation days a year, then 20 days a year after 3 years 26 days a year after 15 years Earn 13 paid sick days each year 11 paid Federal holidays Health benefits including medical, dental, and vision; and access See current SSA job to flexible spending accounts Life insurance Pension benefits under the Federal Employees Retirement System Optional Thrift Savings Plan (similar to a 401K).
The government matches your contribution up to 5% of your salary Flexible work schedules Potential overtime opportunities Potential telework opportunities.
Eligibility for the Public Service Student Loan Forgiveness Program SALARY INCREASES:
GS positions have salary increases based on the number of years of successful performance.
The longer you work for SSA, the more your salary will grow! See OPM GS Pay Schedules (https:
//www.
opm.
gov/policy-data-oversight/pay-leave/salaries- Follow us on LinkedIn wages/) for more information on GS pay tables and locality pay.
COMPETENCY ASSESSMENT INTERVIEW PROCESS (CAIP) INTERVIEW - Applicants will be required to participate in a panel interview (after basic eligibility determination) to demonstrate an aptitude for meeting and dealing with the public.
Applicants must pass this interview process in order to be found fully qualified for this position and receive further consideration for selection.
This interview will cover typical situations, which might be encountered on the job, in person or over the telephone.
Applicants must demonstrate qualities such as clarity of speech, ability to listen, ability to establish confidence and put others at ease and the ability to organize and express thoughts clearly.
If you do not pass the CAIP interview, you will not qualify for the job.
Panel interviews may be conducted via video conferencing software, if technically feasible.
MAKE A DIFFERENCE IN YOUR COMMUNITY! Social Security helps people through their life's journey in many ways.
You will make a positive difference in the lives of people, from all walks of life, who need help applying for retirement, disability, and other critical benefits and services.
Job Type:
Full-time Pay:
$40,918.
00 - $75,013.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Job Type:
Full-time Pay:
$40,918.
00 - $75,013.
00 per year Schedule:
8 hour shift Monday to Friday Work setting:
Hybrid work Office Education:
Bachelor's (Required) Ability to Commute:
Charleston, WV 25301 (Required) Work Location:
Hybrid remote in Charleston, WV 25301.
Estimated Salary: $20 to $28 per hour based on qualifications.
5 Charleston, WV Charleston, WV Full-time Full-time $40,918 - $75,013 a year $40,918 - $75,013 a year 7 days ago 7 days ago 7 days ago This keystone position of the Social Security Administration authorizes entitlements to programs administered by the agency.
The incumbent reviews and authorizes claims and other complex determinations for benefits under Titles II, XVI and/or XVIII of the Social Security Act.
Performs duties involved in one or more of the following:
Title II, Title XVI, XVIII, a generalist in Title II, XVI, and VXIII, a field representative, The incumbent will perform the duties below as it relates to his or her assigned area.
Adjudicates and authorizes entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA.
Develops, investigates, and resolves claims and post-entitlement actions that may involve suspension, resumption, adjustment, or termination of eligibility, or payments.
Conducts inquiries and/or interviews to obtain, clarify, and verify information about individual applicants' initial and continuing eligibility for programs administered by SSA.
Assists the public by explaining the options for conducting business with SSA, including online services.
Informs claimants and/or their representatives about their legal rights and reporting responsibilities.
Examines evidence to evaluate its validity and acceptability in establishing entitlement to benefits, and, when necessary, takes the required developmental actions to obtain all available relevant evidence.
Assists the applicant in securing evidence, electronically records the evidence required, and when applicable, prepares and records special determinations of fact.
Completes development and evaluation of all facts and evidence.
Determines issues in any claim or referred post-adjudicative action, prepares formal or informal determinations relating the facts, evidence and issues to the requirements of the law, regulations, policies and precedents.
Takes related actions to update or establish SSA records.
Responds to contacts from beneficiaries, recipients, the public or other SSA staff by researching inquiries or initiating action to make changes to the claims or beneficiary record.
Develops facts through direct, mail, electronic, or telephone contacts with FOs, PSCs, WSCs/WSUs, FSPs, beneficiaries, or third parties to resolve discrepancies and to obtain complete information.
Performs representational and information activities to secure cooperation of the public; to disseminate facts and advise on program coverage; and to enlist the understanding and cooperation of local organizations.
Provides technical guidance and mentoring (informal and formal) to other employees.
Analyzes and prepares detailed reports of trainee's progress to management, orally or through the appropriate system.
Participates in training sessions both as a student and/or as an instructor, as required.
Protects the rights of individuals by assuring claimants and/or their personal representative understand the claimant's legal rights and obligations under the Act and its relationship to other social welfare and benefit programs.
Assists individuals in filing administrative appeals in the programs administered.
Protects the integrity of SSA programs through identification, investigation, and resolution of potential program abuse/fraud.
When appropriate, determines the need for and makes referrals to the appropriate component.
Properly safeguards personally identifiable information (PII) from loss, theft, or improper disclosure, including inadvertent disclosure, and immediately notifies management of any breach, loss, or potential loss of PII in any form.
Works as an integral part of the unit, office, module, component, team or center, taking all actions necessary to improve overall processing time and quality.
Performs special projects and duties required to achieve the immediate organization's goals.
Participates in studies, projects, etc.
initiated by the unit, module, component, section, office, program service center, area, or SSA Headquarters; analyzes data and prepares reports of study results as required.
Performs other duties as assigned and assumes new responsibilities mandated by legislative or policy changes.
REQUIREMENTS & QUALIFICATIONS U.
S.
Citizenship required Selective Service Registration, if applicable (www.
sss.
gov) Fingerprinting and background and/or security investigation may be required Job offers are contingent on fingerprinting and background / security investigation results Selectees may be required to serve a 1 or 2 year probationary period Relocation expenses will not be paid All qualification requirements must be met by the closing date of the announcement Must pass Competency Assessment Interview Process (CAIP) interview.
Selectees are required to complete a 11-13 week technical training class.
SALARY & ADVANCEMENT Entry into these positions is at the GS-5 and GS-7 level with career ladder advancement opportunity within the position to the GS-11 level.
Salaries are competitive and include locality adjustments based on the job location.
SSA offers promotion opportunities and a wide variety of positions in our numerous offices across the country.
GREAT
Benefits:
Earn 13 paid vacation days a year, then 20 days a year after 3 years 26 days a year after 15 years Earn 13 paid sick days each year 11 paid Federal holidays Health benefits including medical, dental, and vision; and access See current SSA job to flexible spending accounts Life insurance Pension benefits under the Federal Employees Retirement System Optional Thrift Savings Plan (similar to a 401K).
The government matches your contribution up to 5% of your salary Flexible work schedules Potential overtime opportunities Potential telework opportunities.
Eligibility for the Public Service Student Loan Forgiveness Program SALARY INCREASES:
GS positions have salary increases based on the number of years of successful performance.
The longer you work for SSA, the more your salary will grow! See OPM GS Pay Schedules (https:
//www.
opm.
gov/policy-data-oversight/pay-leave/salaries- Follow us on LinkedIn wages/) for more information on GS pay tables and locality pay.
COMPETENCY ASSESSMENT INTERVIEW PROCESS (CAIP) INTERVIEW - Applicants will be required to participate in a panel interview (after basic eligibility determination) to demonstrate an aptitude for meeting and dealing with the public.
Applicants must pass this interview process in order to be found fully qualified for this position and receive further consideration for selection.
This interview will cover typical situations, which might be encountered on the job, in person or over the telephone.
Applicants must demonstrate qualities such as clarity of speech, ability to listen, ability to establish confidence and put others at ease and the ability to organize and express thoughts clearly.
If you do not pass the CAIP interview, you will not qualify for the job.
Panel interviews may be conducted via video conferencing software, if technically feasible.
MAKE A DIFFERENCE IN YOUR COMMUNITY! Social Security helps people through their life's journey in many ways.
You will make a positive difference in the lives of people, from all walks of life, who need help applying for retirement, disability, and other critical benefits and services.
Job Type:
Full-time Pay:
$40,918.
00 - $75,013.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Job Type:
Full-time Pay:
$40,918.
00 - $75,013.
00 per year Schedule:
8 hour shift Monday to Friday Work setting:
Hybrid work Office Education:
Bachelor's (Required) Ability to Commute:
Charleston, WV 25301 (Required) Work Location:
Hybrid remote in Charleston, WV 25301.
Estimated Salary: $20 to $28 per hour based on qualifications.
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