Social Insurance Specialist (Claims Specialist)
AREA OF CONSIDERATION: Current permanent SSA employees in the Philadelphia Region, which includes Baltimore/Washington, D.C./Falls Church headquarters-wide, and OCO Baltimore/WBDOC and 4100 applicants.
The SSA-4100 provision applies to employees whose permanent or temporary duty station is outside of the Philadelphia Region. Employees who currently have an Availability for Assignment form (SSA-4100) on file will not be automatically considered for this position. Employees applying under the 4100 process must complete the electronic filing procedures listed in the How to Apply section.
Applications for noncompetitive consideration will be accepted from SSA employees in the area of consideration who are currently serving under the following types of appointments: Schedule A, Reg. 213.3102 (U) appointments for individuals with disabilities; Veterans Recruitment Appointments; and time limited appointments for veterans with a compensable service-connected disability of 30% or more. Applicants serving under these provisions do not need to submit copies of your disability or Veteran's documentation. However, you must submit a current SF-50 that provides information on the appointment authority under which you were hired. Otherwise, you will not receive non-competitive consideration.
NOTE: Excepted service employees serving under Schedule A appointments for Attorney positions or Pathways Programs appointments (Presidential Management Fellows, Recent Graduates, and Interns) are not eligible for consideration.
LOCATION: This position is located in the Area 3 Field Office, 6295 Edsall Road, Suite 190, Alexandria, VA 22312.
TOUR OF DUTY: Flextime | Full-time | Alternate work schedules may be available.
TYPE OF POSITION: This is a full-time permanent position.
- Not Required
Applicants must have 52 weeks of specialized experience at the next lower grade level, or equivalent, which is in or related to the work of the position to be filled and has equipped applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position.
GS-5: Three years of general experience, one year which was equivalent to the GS-4, that demonstrates the ability to 1) analyze problems to identify significant factors, gather pertinent data, and recognize solutions; 2) plan and organize work; and 3) communicate effectively orally and in writing. Examples of general experience include providing information and assistance to the general public, analyzing, explaining, applying or interpreting laws, rules, regulation or policies.
GS-7: Fifty-two weeks of specialized experience equivalent to the GS-5 grade level. Examples of specialized experience include assisting individuals in filing applications for financial assistance, unemployment, Veterans benefits, insurance benefits, health benefits and/or social service programs; developing, processing, or authorizing claims; explaining benefit related programs to the general public and providing information through the media; or evaluating benefit program policies, procedures and guidelines.
GS-9: Fifty-two weeks of specialized experience at least equivalent to the GS-7 level. Examples of specialized experience include assisting individuals in establishing their entitlement to receive benefits; adjudicating or investigating claims; or evaluating benefit programs to assess the integrity and quality of operations.
GS-11: Fifty-two weeks of specialized experience at least equivalent to the GS-9 level. Examples of specialized experience include developing, examining, investigating or authorizing of claims under a program for SSA benefits, health insurance, pension plan, income maintenance or related programs.
Applicants must also meet the following Selective Placement Factor(s) to qualify for this position:
Meet and deal ability is required.
- Candidates who are in/have held positions requiring meet-and-deal certification do NOT have to submit documentation when applying for this position. Click here to view a list of positions that meet this requirement.
- By the closing date of the announcement, candidates who have not occupied SSA positions for which meet-and-deal ability is required as a selective placement factor MUST upload a completed Certification of Meet and Deal Ability form. If you do not submit the form by the closing date of the announcement, you will be disqualified for the position. If you do not already have this documentation, contact your supervisor or manager.
GS-5: Applicants for promotion must not have held a position lower than GS-3 within the preceding 52 weeks.
GS-7: Applicants for promotion must have 52 weeks at the GS-5 or higher.
GS-9: Applicants for promotion must have 52 weeks at the GS-7 or higher.
GS-11: Applicants for promotion must have 52 weeks at the GS-9 or higher.
Time in grade requirement must be met by the closing date of this announcement.
GS-5: Successful completion of a full 4-year course of study in any field leading to a bachelor's degree. 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 OR a combination of graduate level education and the specialized experience as described below OR a Bachelor's degree and superior academic achievement.
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.
GS-11: Ph.D. or equivalent doctoral degree, or successful completion of three full years of progressively higher level graduate education leading to a Ph.D. or equivalent degree, or LL.M.
Combining Education and Experience:
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.
GS-11: Experience and graduate level education beyond the second year may be combined to meet the minimum qualification requirement.
Note: One year of full-time graduate education is considered to be the number of credit hours that the school you attended has determined to represent one year of study. If this information is not provided, we will consider 18 semester/27 quarter hours to be equal to one year of full-time graduate study.
If selected, you may be required to provide your official college transcripts prior to the effective date of the personnel action placing you into the new position. Experience and education will be computed as percentages of the overall requirements and must equal to 100 percent when combined.
Applicants will be rated using a 100-point scale and evaluated according to the following criteria:
- Experience Assessment: 50 points
- Performance Appraisal: 35 points
- Awards: 10 points
- Career Achievements: 5 points
- Knowledge of SSA mission, principles, objectives, policies, procedures, and entitlement programs.
- Ability to research, interpret and apply standards, directives, policies and legislation.
- Ability to communicate orally.
- Ability to communicate in writing.
- Skill in using online technology and automation tools.
- Ability to manage multiple priorities and balance workloads.
The position description number for this position is 5E2370/A/B/C. A summary of the major duties are listed below. You may also view the full position description on the Agency intranet at the following link: PD Search
This is a developmental position leading to the full performance level of GS-11. Closer supervision and technical guidance and/or on-the-job training are provided. Duties are gradually broadened so the incumbent is eventually performing all of the duties of the full performance level, position description number 5E2370.
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.