Claims Clerk

2 weeks ago

Wilmington, United States Acro Service Corp Full time

Essentially will investigate and write determinations of eligibility based on findings of fact from the claimants and employers as well as help out on phones as needed and other special projects for the unit.


Essential Functions:

  • Reviews unemployment claims against program eligibility requirements by comparing claims to state and federal guidelines regarding the program.
  • Investigating fraudulent claims.
  • Determines claimant's eligibility (non-monetary determination) in accordance with guidelines for benefit administration.
  • Interviews claimants in person, by telephone or by mail in order to make determinations of eligibility.
  • Interviews and corresponds with employers in person, by telephone, or by mail to gain information and distinguish the facts relevant to making eligibility determination.
  • Explains determinations to claimants and employees citing state and federal regulations along with important facts in the case.
  • Explains appeals process to claimants and employers so they may be aware of their rights; take appeals and refer to Appeals Section; attends appeals and testify as a witness.
  • Lends technical guidance to claims processors; may also train and assign work.
  • Sets up overpayment process; interviews claimants receiving overpayments to arrange for recoupment of funds; arranges payment program; notifies Overpayment Unit; tags overpayment files for recovery of payment in future unemployment claims when claimants fail to make restitution or cannot be reached.
  • Takes and processes claims in peak periods.
  • Responds to routine telephone inquires from claimants, employers, and general public such as unemployment check mailing date, how to file for unemployment benefits (procedural questions).

JOB REQUIREMENTS

Applicants must have education, training and/or experience demonstrating competence in each of the following areas:

  • Six months experience in health or human services support such as interviewing clients and assessing personal, health, social or financial needs in accordance with program requirements or coordinating with community resources to obtain client services.
  • Six months experience in record keeping.
  • Six months experience in applying laws, rules, regulations, standards, policies and procedures.
  • Six months experience in using an automated information system to enter, update, modify, delete, retrieve/inquire and report on data.

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