Claims Examiner

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Annual Salary Range:
$26,136.00 – $35,844.00
Twice-a-Month Salary Range:
$1,089.00 – $1,493.50
Class Number: 
0719
Pay Grade: 
A14
Areas of Interest: 
Business Services
Exam Components: 
Written Examination, 100%
Definition

This is entry-level technical work in administering the unemployment insurance claims program of the Missouri Division of Employment Security.

This description may not include all of the duties, knowledge, skills, or abilities associated with this classification.
Examples of Work

Receives basic unemployment insurance claims for new and renewed claims for both state and federal benefits, and processes continued claims.

Reviews eligibility for benefits of claimants scheduled for Eligibility Review Program (ERP) telephone interviews.

Prepares standard form letter responses to correspondence relating to unemployment insurance claims.

Reviews a variety of data on claims records for technical accuracy prior to entering it into the computer.

Inputs and retrieves unemployment insurance claims information using a computer terminal.

Receives and examines federal unemployment insurance claims, Unemployment Compensation for Federal Employees (UCFE), and Unemployment Compensation for Ex-service Members (UCX); determines whether a veteran has qualifying military service and establishes the base period and subsequent wages for veterans who do qualify; makes monetary determinations based on "covered" wages; and makes redeterminations of claims previously filed as state claims for which wages from federal or military service are applicable.

Corrects and handles items and situations occurring in the processing of unemployment insurance claims such as: transferring of Missouri wage credits to other states and notifying other states of their share of benefits paid to a claimant in Missouri; processing of additional wage credits including the monetary redeterminations; preparing control documents on duplicate claims and EDP error listings; and processing requests for supplemental checks and benefit year corrections.

Adjusts continued claims and forged and lost unemployment insurance checks; processes IB-14 forms regarding missing wages on combined wage claims; processes Federal withholding forms; enters work search waiver information; and takes calls from claimants to delete personal identification number and/or change the individual’s mailing address.

Reviews incoming appeal requests and related correspondence for completeness and possible reconsideration or setting of appeals; makes calls to obtain missing information; retrieves all imaged documents relating to issues appealed.

Refers issues that should be reconsidered to the proper Regional Claims Center.

Receives supervision from a Claims Supervisor or other designated supervisor; however, the employee is expected to handle ordinary assignments within the framework of well-defined policies and procedures.

Performs other related work as assigned.

Knowledge, Skills, and Abilities (KSAs)

Introductory knowledge of, and the ability to apply, interviewing techniques in practical work situations.

Introductory knowledge of the purpose and overall objectives of Employment Security Programs.

Introductory knowledge of the techniques, procedures, and policies involved in the processing of claims for unemployment insurance and allowances under training programs.

Introductory knowledge of state and federal laws and regulations pertaining to unemployment insurance.

Introductory knowledge of general office procedures, practices, and equipment.

Skill in typing accurately from rough draft or plain copy.

Ability to establish and maintain effective working relationships with claimants, employers, and coworkers.

Ability to understand and follow complex directions.

Ability to obtain basic facts and apply them to specific situations.

Ability to use a computer terminal for data entry and inquiry.

Ability to retrieve and apply stored information.

Ability to make accurate arithmetical computations.

Ability to work rapidly and accurately in examining and processing a variety of documents.

Experience and Education

(The following requirements will determine merit system eligibility, experience and education ratings, and may be used to evaluate applicants for Missouri Uniform Classification and Pay System positions not requiring selection from merit registers.  When practical and possible, the Division of Personnel will accept substitution of experience and education on a year-for-year basis.) 

One or more years of experience as a Senior Office Support Assistant with the Missouri Division of Employment Security; and possession of a high school diploma or proof of high school equivalency. 

OR 

Three or more years of experience as an Office Support Assistant with the Missouri Division of Employment Security; and possession of a high school diploma or proof of high school equivalency.

OR 

Three or more years of experience in phone sales/consultation, commercial sales, or persuasive sales; public contact work in reception, credit interviewing, or handling complaints; or in bookkeeping or processing insurance claims; and possession of a high school diploma or proof of high school equivalency. 

(Earned credit hours from an accredited college or university may substitute on a year-for-year basis for the required experience at a rate of 30 earned credit hours for one year.)

(Minor Revision 11/1/13)