Claims Specialist

Job posting
Closing date: 18 May 2021

Chances are, you either receive Social Security benefits or know someone close to you who does. Social Security has provided financial protection for our nation's people for over 80 years. With Retirement, Disability, and Survivors benefits, Social Security is one of the most successful anti-poverty programs in our nation's history. We are one of the largest independent agencies in government with over 60,000 employees.  We are passionate about supporting our customers by delivering financial support, providing superior customer service, and ensuring the safety and security of the American public.

 

Claims Specialists conduct interviews with the public to obtain, clarify, and verify information about initial and continuing eligibility for retirement, survivors, disability, Medicare, and supplemental security income benefits. The ability to deal with the public in a fast-paced customer service setting. Work experience in customer service is beneficial.

  • Provides direct service to the general public addressing all facets of the SSA benefit programs

  • Conducts face-to-face and telephone interviews with the public to determine eligibility and continuing eligibility for benefits

  • Provides assistance with all areas of administrative appeals

  • Makes payment or denial decisions based on the evidence submitted

  • Offers a variety of referral services

  • Identifies and investigates allegations of potential fraud and abuse.

  • Use state of-the-art technology to access and update claims information

  • Entry into these positions is at the GS-5 or GS-7 level with advancement opportunity within the position to the GS-11 level. Further career development includes, but is not limited to, technical expert and management positions.

How to apply

Position: Claims Specialist

The Social Security Administration is one of the largest independent agencies in government with over 60,000 employees. We work at more than 1,400 field offices and service centers throughout the country, as well as regional and headquarters locations.

Our mission is to “Deliver Social Security Services that meet the changing needs of the public”. The Social Security Administration (SSA) administers the following federal benefits programs: retirement, survivors, disability, Medicare, and supplemental security income benefits. This is a public contact agency that takes great pride in providing exemplary customer service to a broad spectrum of people.

Skills We Look For

  • Good written and oral communication skills

  • Good people skills

  • Skills in independent analysis and problem solving using policies, procedures, laws, and regulations

Social Security offers generous benefits and leave policies, flexible schedules, and many special programs to support employees who need help when faced with life’s changes and challenges. We promote and value a healthy balance between job responsibilities and family life for all employees. You will be eligible to participate in a retirement program, thrift savings plan, health benefits for individuals/families and life insurance. There are 10 paid federal holidays per year.

Please visit us online for more information about career opportunities with the Social Security Administration at https://www.ssa.gov/careers/

Duties

Claims Specialists conduct interviews with the public to obtain, clarify, and verify information about initial and continuing eligibility for retirement, survivors, disability, Medicare, and supplemental security income benefits. The ability to deal with the public in a fast-paced customer service setting. Work experience in customer service is beneficial.

  • Provides direct service to the general public addressing all facets of the SSA benefit programs

  • Conducts face-to-face and telephone interviews with the public to determine eligibility and continuing eligibility for benefits

  • Provides assistance with all areas of administrative appeals

  • Makes payment or denial decisions based on the evidence submitted

  • Offers a variety of referral services

  • Identifies and investigates allegations of potential fraud and abuse.

  • Use state of-the-art technology to access and update claims information

  • Entry into these positions is at the GS-5 or GS-7 level with advancement opportunity within the position to the GS-11 level. Further career development includes, but is not limited to, technical expert and management positions.

Qualifications

GS-5: Three years of general experience that demonstrates the ability to 1) analyze problems, identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; 3) communicate effectively orally and in writing; and using online technology and automation tools. Examples of qualifying experience include analyzing, explaining, applying or interpreting laws, rules, regulation or policies.

GS-7: Fifty-two weeks of specialized experience in 1) assisting individuals in establishing their entitlement to receive benefits; 2) adjudicating, authorizing or reconsidering claims; 3) representing benefit programs before the general public; 4) evaluating benefit program operations to assess the integrity and quality; or 5) interpreting benefit program requirements and formulating policies, procedures and guidelines.

SUBSTITUTING EDUCATION: If you are qualifying for this position based on completed education at an accredited college or university, you must provide a copy of your official or unofficial college transcripts or other proof of education.

GS-5: Completion of a full 4-year course of study in any field leading to a bachelor's degree OR a combination of post-high school education and the general experience described above. One year of study is defined as 30 semester hours or 45 quarter hours.

GS-7: One full year of graduate level education in any field. One year of full-time graduate study is defined as 18 semester hours or 27 quarter hours. A combination of graduate level education and the specialized experience as described above OR a Bachelor's degree and superior academic achievement in any field can be applied as a substitution. Superior academic achievement is based on:

  • Graduated in the upper third of the graduating class in the college, university, or major subdivision; OR

  • Graduated with a cumulative 3.0 GPA or higher out of 4.0 based on 4 years of education, or based on courses completed during the final 2 years of the curriculum. OR

  • Graduated with a 3.5 GPA or higher based on the average of all the required courses completed in the major field or the required courses in the major field completed during the final 2 years of the curriculum; OR

  • Election to membership in a national scholastic honor society that meets the minimum requirements of the Association of College Honor Societies (except for freshman honor societies).

Salary

Entry level GS-5/GS-7 ($38,665/$47,895) advancing to GS-11 ($70,883).

Location

Littleton, CO 80120
United States
Non-Competitive Eligibility (NCE):
Yes

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