Claims Specialist (Social Insurance Specialist)
3.
5 Pittsburgh, PA Pittsburgh, PA Full-time Full-time $40,918 - $61,999 a year $40,918 - $61,999 a year 22 hours ago 22 hours ago 22 hours ago 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; and use state of-the-art technology to access and update claims information.
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 QUALIFICATIONS Social Insurance Specialist (Claims Specialist) (GS-105-5/7/9) 05E2370 TOP 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) analyze problems, identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; 3) communicate effectively orally and in writing; and 4) use 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 at the GS-5 grade level or equivalent in the federal service 1) assisting individuals in establishing their entitlement to receive benefits; 2) adjudicating, authorizing or reconsidering claims; 3) explaining benefit entitlements or requirements to the general public; 4) evaluating benefit program operations to assess the integrity and quality; or 5) interpreting benefit program requirements to formulate policies, procedures or guidelines.
GS-9:
Fifty-two weeks of specialized experience equivalent to the next lower grade level in the federal service in 1) assisting individuals in establishing their entitlement to receive benefits; 2) adjudicating or investigating claims; or 3) evaluating benefit programs to assess the integrity and quality of operations.
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.
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.
Qualifications 4 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).
GS-9:
Master's or equivalent graduate degree, or successful completion of two academic years of progressively higher graduate education, or LL.
B.
or J.
D.
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.
GS-9:
Experience and graduate level education beyond the first year may be combined to meet the minimum qualification requirement.
Experience and education will be computed as percentages of the overall requirements and must equal to 100 percent when combined.
SELECTIVE PLACEMENT FACTOR Meet and Deal Panel Interview:
Applicants will be required to participate in a structured panel interview to demonstrate an aptitude for meeting and dealing with the public.
This interview will be administered/conducted utilizing the Competency Assessment Interview Process (CAIP).
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.
Candidates 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 Meet and Deal panel interview, you will not qualify for the job.
Job Type:
Full-time Pay:
$40,918.
00 - $61,999.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Parental leave Retirement plan Tuition reimbursement Vision insurance Work from home Schedule:
8 hour shift Day shift Monday to Friday Work setting:
Hybrid work Office Work Location:
Hybrid remote in Pittsburgh, PA 15219.
Estimated Salary: $20 to $28 per hour based on qualifications.
5 Pittsburgh, PA Pittsburgh, PA Full-time Full-time $40,918 - $61,999 a year $40,918 - $61,999 a year 22 hours ago 22 hours ago 22 hours ago 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; and use state of-the-art technology to access and update claims information.
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 QUALIFICATIONS Social Insurance Specialist (Claims Specialist) (GS-105-5/7/9) 05E2370 TOP 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) analyze problems, identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; 3) communicate effectively orally and in writing; and 4) use 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 at the GS-5 grade level or equivalent in the federal service 1) assisting individuals in establishing their entitlement to receive benefits; 2) adjudicating, authorizing or reconsidering claims; 3) explaining benefit entitlements or requirements to the general public; 4) evaluating benefit program operations to assess the integrity and quality; or 5) interpreting benefit program requirements to formulate policies, procedures or guidelines.
GS-9:
Fifty-two weeks of specialized experience equivalent to the next lower grade level in the federal service in 1) assisting individuals in establishing their entitlement to receive benefits; 2) adjudicating or investigating claims; or 3) evaluating benefit programs to assess the integrity and quality of operations.
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.
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.
Qualifications 4 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).
GS-9:
Master's or equivalent graduate degree, or successful completion of two academic years of progressively higher graduate education, or LL.
B.
or J.
D.
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.
GS-9:
Experience and graduate level education beyond the first year may be combined to meet the minimum qualification requirement.
Experience and education will be computed as percentages of the overall requirements and must equal to 100 percent when combined.
SELECTIVE PLACEMENT FACTOR Meet and Deal Panel Interview:
Applicants will be required to participate in a structured panel interview to demonstrate an aptitude for meeting and dealing with the public.
This interview will be administered/conducted utilizing the Competency Assessment Interview Process (CAIP).
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.
Candidates 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 Meet and Deal panel interview, you will not qualify for the job.
Job Type:
Full-time Pay:
$40,918.
00 - $61,999.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Parental leave Retirement plan Tuition reimbursement Vision insurance Work from home Schedule:
8 hour shift Day shift Monday to Friday Work setting:
Hybrid work Office Work Location:
Hybrid remote in Pittsburgh, PA 15219.
Estimated Salary: $20 to $28 per hour based on qualifications.
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