Social Insurance Specialist (Claims Specialist)
Posted 9 months ago by Haresh
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.
These positions are located in the Bedford Heights Field Office; Boro Hall Field Office; Bushwick Field Office; Canarsie Field Office; Cypress Hills Field Office; East Bronx Field Office; East Village Field Office; Flatbush Field Office; Flushing Field Office; Hunts Point Field Office; Hylan Boulevard Field Office; Inwood Hill Field Office; Jamaica Field Office; Laconia Avenue Field Office; Long Island City Field Office; Midtown Field Office; New Utrecht Field Office; North Bronx Field Office; Rego Park Field Office; Rockaway Park Field Office; South Bronx Field Office; Staten Island Field Office; Uptown Field Office; West Farms Field Office.
To be considered for the Bedford Heights, Boro Hall, Bushwick, Canarsie, Cypress Hills, Flatbush and New Utrecht field offices, you must select the Brooklyn, NY location and may be placed in any location.
To be considered for the East Bronx, Hunts Point, Laconia Avenue, North Bronx, South Bronx and West Farms field offices, you must select the Bronx, NY location and may be placed in any location.
To be considered for the Flushing, Jamaica, Long Island City, Rego Park and Rockaway Park field offices you must select the Queens, NY location and may be placed in any location.
To be considered for the East Village, Inwood Hill, Midtown and Uptown field offices you must select the New York, NY location and may be placed in any location.
To be considered for the Hylan Boulevard, Staten Island, NY and Staten Island field offices you must select the Richmond, NY location and may be placed in either location.
NOTE : This position is being filled on a full-time, permanent basis. Additional selections may be made within six months from the closing date of this announcement.
This is a career-ladder position leading to the GS-11 grade level.
All qualification requirements must be met by the closing date of the announcement.
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.
Job family (Series)
0105 Social Insurance Administration
Conditions of Employment
U.S. Citizenship required
Selective Service Registration, if applicable (www.sss.gov)
Background and/or security investigation required
Job offers are contingent on background / security investigation results
Selectees are required to serve a 1 year probationary period
Relocation expenses will not be paid
Complete the initial online assessment and USA Hire Assessment, if required
All qualification requirements must be met by the closing date of the announcement. If you are using experience to qualify, you must have:
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.
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
Meet and Deal Panel 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. 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. If you have previously taken and passed the Meet and Deal Interview, please submit a copy of your notice as verification. If you have previously held a SSA position subject to the Meet and Deal Interview requirement, please upload a copy of a SF-50, Notification of Personnel Action, as verification that you have held such a position.
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 all 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-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-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.
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 .
Reasonable Accommodation Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended and Americans with Disabilities Act 1990 as amended, that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a reasonable accommodation in your online application. Requests for Reasonable Accommodations for the USA Hire Competency Based Assessments and appropriate supporting documentation for Reasonable Accommodation must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for Reasonable Accommodations are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments. To determine if you need a Reasonable Accommodation, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
The evaluation you receive is based on your responses to the online assessments completed during the application process. You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):
Attention to Detail
Knowledge of federal laws, rules, 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.
Please make sure you answer all questions and follow all instructions carefully. Errors or omissions may affect your evaluation.
Your application will be evaluated under the Category Rating method, based on your responses to the Assessment Questions. If you meet the basic requirements for the position, your application will be evaluated and placed into one of three categories:
1 – Qualified Category – Candidates who meet the Minimum Qualification Requirements.
2 – Well Qualified Category – Candidates who meet the Minimum Qualification Requirements and demonstrate a satisfactory level of the knowledge, skills, and abilities necessary to perform the duties of the position.
3 – Best Qualified Category – Candidates who meet the Minimum Qualification Requirements and demonstrate a high level of the knowledge, skills, and abilities necessary to perform the duties of the position.
Candidates eligible for veterans’ preference will be placed ahead of other candidates in the appropriate category for which they have been rated. Additionally, preference eligibles who have a compensable service-connected disability of at least 10 percent and who meet the Minimum Qualification Requirements will automatically be placed in the Best Qualified Category.
ICTAP candidates who meet the requirements for the Well Qualified category will be placed at the top of the Best Qualified category and be given selection priority.
Background checks and security clearance
Public Trust – Background Investigation
To apply for this position, you must submit a complete Application Package which includes:
1. Your resume showing work schedule, hours worked per week, dates of employment and duties performed.
2. Other supporting documents:
If you are requesting a reasonable accommodation to the USA Hire Competency Based Assessments, submit documentation to support your request, including the Reasonable Accommodation Request Form found here: https://help.usastaffing.gov/Apply/index.php?title=Reasonable_Accommodations_for_USA_Hire
Transcripts (if using education to qualify – unofficial copies accepted)
You must also submit ALL supporting documentation by the closing date of the vacancy announcement to claim certain types of preference or qualify on the basis of education.
INTERAGENCY CAREER TRANSITION ASSISTANCE PLAN (ICTAP): ICTAP provides eligible displaced Federal competitive service employees with selection priority for competitive service vacancies. To receive selection priority, candidates must meet the requirements for the Well Qualified category as described in the vacancy announcement. Candidates must also provide:
proof of eligibility with your application. Such proof may include a copy of your written notification of ICTAP eligibility or a copy of your separation Notice of Personnel Action, (SF-50); and
proof of your most recent performance rating of at least “fully successful” (Level III) or equivalent.
For more information visit http://www.opm.gov/rif/employee_guides/career_transition.asp .
VETERANS’ PREFERENCE: If you are claiming veterans’ preference, you must submit a copy of your military discharge certificate (DD 214 member 4 copy) or an official statement of service from your command if you are currently on active duty. To be acceptable, the document must show Character of Service. If you are claiming 10-point veterans’ preference based on a service-connected disability, you must also submit the required documentation specified on the reverse of the SF-15, Application for 10-Point Veterans’ Preference (SF 15) . Applicants claiming derived preference must submit the veteran’s DD 214 in addition to the SF-15 and the required documentation specified on the reverse of the SF 15. Preference will be granted based on the documents received. For more information visit the Vet Guide .
IMPORTANT NOTICE TO VETERANS : The Office of Personnel Management has published the end date for Operation Iraqi Freedom (OIF) as August 31, 2010. To receive veterans’ preference for service during the Enduring Freedom/Iraqi Freedom era, you must have served for more than 180 days between September 11, 2001 and August 31, 2010 OR be in receipt of a campaign badge or expeditionary medal. The updated CFR language is available here . Other qualifying eligibility for preference (e.g., disability) remains unchanged.
PROOF OF EDUCATION: If you are qualifying on the basis of education or satisfying an educational requirement, submit a copy of ALL your transcripts that includes your name, the name of the educational institution, course title(s), number of credits, grade, and date of completion. Unofficial transcripts or screenshots of electronic/web transcripts with the required information will be accepted at the time of application. You must submit your transcripts according to the application submission details of this announcement. Documents will not be accepted via email or regular mail. 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.
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education .
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits .
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.