Claim Specialist

Summary of Duties:

• Work in our local office speaking with people who already receive or are applying for Social Security benefits.
• Interview people applying for benefits in person or by telephone.
• Gather facts and evidence to determine if someone is eligible for benefits.
• Review and analyze evidence; determine if someone is eligible for benefits.
• Help the public by answering a wide variety of questions both in-person and by telephone.
• Conduct interviews, investigate situations, and resolve issues.
• Review information to determine ongoing eligibility for Social Security benefits.
• Analyze a claimant's benefit payment history.
• Demonstrate excellent customer service skills.
• Demonstrate excellent verbal and written communication.
• Efficiently adapt to changes in work priorities.

*** Please note that paid technical training is provided by the employer.

• This keystone position of the Social Security Administration (SSA) authorizes entitlements to programs administered by the agency. The incumbent reviews and authorizes claims and other complex determinations for benefits under Titles 2, 16 and/or 18 of the Social Security Act.
• 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 Field Offices, Payment Centers, Workload Support Units, 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.
• 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 office, taking all actions necessary to improve overall processing time and quality. Performs…