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CLAIMS SPECIALIST

Madison, WI, United States

JOB REQUIREMENTS: Interpret and explain information such as eligibility requirements, application details, payment methods, and applicants' legal rights. Interview benefits recipients at specified intervals to certify their eligibility for continuing benefits. Keep records of assigned cases, and prepare required reports. Compile, record, and evaluate personal and financial data to verify completeness and accuracy, and to determine eligibility status. Answer applicants' questions about benefits and claim procedures. Interview and investigate applicants for public assistance to gather information pertinent to their applications. Initiate procedures to grant, modify, deny, or terminate assistance, or refer applicants to other agencies for assistance. Check with employers or other references to verify answers and obtain further information. Compute and authorize amounts of assistance for programs, such as grants, monetary payments, and food stamps. Schedule benefits claimants for adjudication interviews to address questions of eligibility. Investigate claimants for the possibility of fraud or abuse. Monitor the payments of benefits throughout the duration of a claim. Provide applicants with assistance in completing application forms, such as those for job referrals or unemployment compensation claims. ***** OTHER EXPERIENCE AND QUALIFICATIONS: At the full performance level, the incumbent will conduct interviews with the public to obtain, clarify and verify information about initial and continuing eligibility for retirement, survivors, disability health insurance benefits and eligibility for supplemental security income including State supplements; resolve discrepancies, clarify issues and make final decisions for initial and post-entitlement for benefits and payments; adjudicate and authorize entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA; and use state of-the-art technology to access and update claims information. General experience that demonstrates the ability to analyze problems to identify significant factors, gather pertinent data, and recognize solutions; plan and organize work; and communicate effectively orally and in writing. ***** APPLICATION INSTRUCTIONS: E-Mail a Rsum: [email protected]

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