Social Insurance Specialist (Claims Specialist)

Social Security Administration
Reston, VA
Oct 18, 2021
Oct 20, 2021
Accountant, IT
Full Time
Summary This position is located in our Reston VA Field Office, 10800 PARKRIDGE BLVD, Suite 100, RESTON VA 20191. Promotion Potential: The GS-11 is the full performance level. Responsibilities The Social Insurance Specialist (Claims Specialist) reviews and authorizes claims and other complex determinations for benefits under Titles II, XVI and/or XVIII of the Social Security Act. 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. 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. Requirements Conditions of Employment Qualifications 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. All qualification requirements must be met by the closing date of the announcement. If you are using experience to qualify, you must have: 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. Note: Part-time work is prorated in crediting experience (eg, if you work 20 hours per week for a 12 month period, you will be credited with 6 months of experience). Education Substituting Education For information on substituting education for experience, visit -stds/gs-cler.asp 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-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. Additional Information In addition to the minimum qualifications, applicants must be eligible under one of the following categories:Displaced or surplus Federal employees eligible under the Interagency Career Transition Assistance Plan (ICTAP). Veterans who are eligible for preference OR who have been separated from the armed forces under honorable conditions after 3 or more years of continuous service, including veterans who were separated shortly before completing the required 3-year period, are eligible for consideration under the Veterans Employment Opportunity Act (VEOA). In addition to meeting the basic eligibility criteria, ICTAP applicants must be well qualified for the position. Well-qualified is defined as having knowledge, skills, and abilities that clearly exceed the minimum qualification requirements for the position. Under numeric rating procedures, qualified ICTAP applicants must receive a rating of 85 or higher to be eligible for selection. Military Spouse Appointing Authority. You may be eligible for an appointment under the Military Spouse Appointing Authority if you are: 1) The spouse of an active duty member of the armed forces; 2) The spouse of a former service member who is 100% disabled due to a service-connected disability; or 3) The un-remarried widow or widower of a service member killed while on active duty. Each of these categories has different eligibility criteria that must be met. Individuals applying for consideration under this authority MUST provide the applicable supporting documentation (eg, documentation verifying marriage, DD-214 member 4, copy of a statement from the Department of Veterans Affairs or a branch of the military certifying the service member's service-connected disability rating, DD-1300, statement from military installation certifying current active duty etc.). You are no longer eligible if you remarry. 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 Additional selections may be made for this vacancy six months from the closing date of this announcement.

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