Claims Specialist

Starting Salary is either GS 5 or GS 7 with full performance potential to GS 11.

Duties

Once selected for the Claims Specialist position in SSA, you will contribute to the Agency's mission through direct and personal service to the public. This includes speaking with beneficiaries about their rights under the Social Security laws, gathering facts and evidence to establish eligibility for benefits, making critical decisions to determine the amount of benefits paid to individuals, and using state-of-the-art computer technology to access and update information about claims. Claims Specialists 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. In addition, they 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.

Requirements

Conditions of Employment

• 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 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 12-14 week technical training class.

Qualifications

All qualification requirements must be met by the closing date of the announcement. If you are using experience to qualify, you must have: GS-5: Three years of general experience equivalent to the next lower grade level in the federal service that demonstrates the ability to 1) review problems to identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; and 3) communicate effectively orally and in writing. An example of qualifying experience include reviewing, explaining, applying or interpreting rules, regulation or policies. GS-7: One (1) year of specialized experience at the GS-5 level (or equivalent) that demonstrates the ability to (1) assist individuals in establishing their entitlement to receive benefits (e.g., retirement, disability, public aid, insurance, taxes, etc.); (2) adjudicate, authorize or reconsider claims; (3) explain benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) entitlements or requirements to the general public; (4) evaluate benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program operations to assess the integrity and quality; or (5) interpret benefit (e.g., retirement, disability, public aid, insurance, taxes, etc.) program requirements to formulate policies, procedures or guidelines. Note: Part-time work is prorated in crediting experience (e.g., if you work 20 hours per week for a 12-month period), you will be credited with 6 months of experience. SELECTIVE PLACEMENT FACTOR 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. NOTE: Previous Meet and Deal results are not valid for this vacancy announcement; you will be required to complete the CAIP assessment.

Education

SUBSTITUTING EDUCATION: If you are qualifying for this position based on completed education at an accredited U.S. college, university, or other educational institution, you must provide a copy of your transcripts or other proof of education prior to being appointed. NOTE: Education completed in a foreign institution must be deemed equivalent to that gained in conventional/accredited U.S. education programs. It is the applicant's responsibility to acquire U.S. Certification and provide it at the time of application. For a list of Credential Evaluation Services, log on to: Credential Evaluation Services. 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 earned semester hours or 45 earned quarter hours. GS-7: One full year of graduate level education in any field. One year of full-time graduate education is defined as 18 earned semester hours or 27 earned 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).

COMBINING EDUCATION AND EXPERIENCE: Experience and education as described above may be combined to meet the minimum qualification requirements. GS-5: Experience and education as described above may be combined to meet the minimum qualification requirements. GS-7: Experience and graduate level education as described above may be combined to meet the minimum qualification requirements. Experience and education will be computed as percentages of the overall requirements and must equal to 100 percent when combined. For information on providing proof of education or substituting education for experience, visit General Schedule Qualification Standards (opm.gov)

Additional information

NOTE: Telework may be available in accordance with agency policy. This IS NOT a virtual position. This is a career-ladder position offering the opportunity for annual promotion based on performance leading up to the GS-11 grade level. Normally candidates are hired at step one unless they have prior federal experience with no break in service. This is a bargaining unit position represented by the American Federation of Government Employees. Selective Service: If you are a male applicant born after December 31, 1959, you must certify that you have registered with the Selective Service System, or are exempt from having to do so under the Selective Service Law. See www.sss.gov.

“SSA is hiring! Please see attached posting. Please note that while I work for SSA, I am posting this in my personal capacity for informational purposes only. If you have any questions relating to this job posting and/or wish to apply for the position, please refer to the official instructions in the posting.”

Job Type: Full-time

Pay: $46,643.00 - $57,778.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift

Ability to commute/relocate:

• San Rafael, CA 94903: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Microsoft Office: 1 year (Preferred)
• Customer service: 1 year (Preferred)

Work Location: One location

Salary : $46,643 - $57,778