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ACOM DWS CLAIMS ADJUDICATOR
The Department of Workforce Services (DWS) Claims Adjudicator is responsible for examining and deciding unemployment insurance claims. This position is governed by state and federal laws and agency/institution policy.
Class Code:
X183C
Job Grade:
GS03
Special Job Requirements:
None
Typical Functions:
Examines unemployment insurance claims for accuracy and completeness by checking claim forms for missing information and comparing wages, period, and type of employment to source data on computer or in claimant’s files. Communicates with claimants/potential debtors/agencies paying and/or transferring state by telephone and written correspondence to obtain additional claims information and/or financial information. Accesses computer terminal to enter, check, and retrieve information concerning claimant/debtor data. Determines outcome of claims by making initial claim determination, monetary and non-monetary determinations, re-determinations, and supplemental and overpayment determinations, according to agency policies, laws, and regulations. Calculates overpayment amounts according to agency policies, laws, and regulations, and enters overpayment information into computer system. If fraud is suspected refers for appropriate action. Maintains an accurate monthly/quarterly billing and collection system. Maintains program records by posting to computer/journal/ledgers or other filing systems. Provides training/technical assistance and responds to inquiries regarding overpayment determinations and supplemental payments. Performs other duties as assigned.
Knowledge, Abilities, and Skills:
Knowledge of unemployment insurance rules and regulations. Knowledge of basic mathematical calculations. Ability to review and analyze information and make decisions, according to agency policies, laws, and regulations. Ability to provide technical assistance on unemployment insurance claims. Ability communicate orally and in writing. Ability to utilize the Windows computer operating system.
Minimum Qualifications:
The formal education equivalent of a high school diploma; plus three years of experience in a clerical field, including one year in reviewing unemployment insurance claims. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
Required Certificates:
None
Exempt:
N
