Claims Specialist II

  • Claims Specialist II
  • What will I be doing?
  • Do I qualify?
  • Can I be successful?
  • Benefits
  • How do I apply?
Class Number: 
0782
Exam Components: 
Non-Competitive Registration
Annual Salary Range:
$30,768.00 – $49,248.00
Twice-a-Month Salary Range:
$1,282.00 – $2,052.00
Pay Grade: 
05

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Definition

This is mid-level professional interviewing and related work in the unemployment insurance benefit/claims program of the Missouri Division of Employment Security.

Job Duties

Assumes responsibility for difficult and complex activities involved in securing and evaluating information required to process state and federal unemployment insurance claims; shared work claims; and claims for training, subsistence, and transportation allowances under various employability programs.

Files claims under state and federal unemployment insurance programs; investigates and adjudicates disputed claims; and verifies eligibility for federal allowance payments.

Secures detailed information from claimants and enters data into the computer system; determines the type of unemployment claim to be filed under state and federal unemployment insurance programs.

Secures, documents, and investigates detailed and sensitive information from claimants involved in disputed claims, including such complicated issues as separation from work, availability for work, refusal of work, participation in a labor dispute, and overpayment investigations.

Secures and documents additional technical information from employers and other interested parties by telephone interviews and correspondence to obtain complete facts.

Obtains facts and issues determinations relevant to a trainee’s eligibility status for allowances under employability programs.

Evaluates information, applies proper section of the law to the facts, and prepares non-monetary determinations for forwarding to interested parties.

Reviews and evaluates new information received after a determination has been issued and decides if an appeal or different determination is necessary.

Interviews claimants and secures information concerning previous wages earned and weeks worked; determines if additional wage credits should be applied or if there is an overpayment of benefits.

Corresponds and communicates with claimants, employers, Central Office, and state and federal agencies to correct errors, resolve problems, and facilitate claims processing.

Attends training sessions and meetings to remain aware of program procedures and law changes.

Assists in preparation of case materials and coordinates with prosecuting attorneys throughout the state for presentation of cases involving fraudulently filed unemployment insurance claims.

Assists in training new agency staff in filing unemployment insurance claims, fact-finding and determination writing processes, and related procedures.

Applies established procedures for control of overpayment and fraud on all types of claims.

Receives assignments in cases of potential overpayment of erroneous or fraudulent claims; collects and evaluates information; and establishes facts and makes recommendations and determinations consistent with law.

Resolves complex claims processing problems in compliance with state and federal laws and regulations.

Studies new and revised agency procedures, rules, laws, regulations, and other program changes contained in manuals to maintain currency of knowledge and information.

Interviews claimants with outstanding overpayments and arranges for restitution including civil action.

Provides basic oversight and review of the work performed by employees in lower-level positions.

Exercises independent judgment and initiative within established policies and procedures; receives general supervision.

Performs other related work as assigned.

Areas of Interest: 
BUSINESS SERVICES

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(The following minimum qualifications will determine merit system eligibility. Allowable experience and education substitutions are provided in italics below the corresponding minimum qualification statement; no other substitutions will be permitted. These minimum qualifications may also be used to evaluate applicants for Missouri Uniform Classification and Pay System positions not requiring selection from merit registers.)

One or more years of experience as a Claims Specialist I or Contributions Specialist I with the Missouri Division of Employment Security; and possession of a high school diploma or proof of high school equivalency.

OR

A Bachelor’s degree from an accredited college or university; and,

One or more years of professional experience involving public contact work in the areas of social services; education; community organization; business, personnel, and/or public administration, or a closely related area; and/or in a state or federal unemployment insurance program.

(24 earned graduate credit hours from an accredited college or university may substitute for the stated experience.)

(Technical experience involving public contact work in the above specified areas, or a closely related area; and/or senior-level clerical experience with the Missouri Division of Employment Security may substitute on a year-for-year basis for deficiencies in the stated college education.)

Please note that documentation that supports your eligibility (i.e. transcripts, employment records, etc.) may be required at any time during the application and hiring process. If you do not possess the minimum qualifications, please consider one of many other employment opportunities with the State of Missouri.

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Key Skills

Do you possess the key skills which are considered essential for successful employment in this classification?

Intermediate knowledge of interviewing and investigative techniques and procedures required in processing unemployment insurance claims.

Intermediate knowledge of the principles, objectives, and regulations underlying the unemployment insurance program and of the applicable state and federal laws.

Intermediate knowledge of office procedures, practices, and equipment.

Ability to obtain and document essential facts clearly and concisely, evaluate information, and make determinations on the basis of established rules and precedents.

Ability to organize and prioritize workload to meet assigned timeframes and adapt to changes in policy, procedures, and work assignments.

Ability to communicate effectively.

Ability to use office equipment and personal computer.

Ability to work rapidly and accurately.

Ability to make accurate mathematical computations.

Ability to establish and maintain effective working relationships with claimants, employers, coworkers, and representatives, such as accountants and attorneys.

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The following link will provide you with general information about State of Missouri employee benefits.

View benefits

View Class Specification Document