
Accomplished Claims Technical Expert recognized for maintaining exceptional performance levels in claims management. Expertise in Social Security and SSI regulations, coupled with strong problem-solving and communication skills, driving successful outcomes in complex case adjudication.
During the 20 years that I was a Claims Technical Expert I maintained a fully successful performance level at each fiscal year end appraisal. I was responsible for maintaining and handling the SSI PE workloads including Redeterminations, Overpayments, Post Entitlement changes, Medical and Work CDR's, and Medical and Non Medical Appeals. At various times during the years I also took and adjudicated Disability, Retirement, Survivor and Medicare claims. I have served as a mentor for several claims representatives, and have helped solved and adjudicated some of the most complex cases. I have provided technical training as needed. I have also helped other offices in the area with backlogs of overpayments, redeterminations and medical and work CDR's.
I maintained a workload of SSI PE including redeterminations, overpayments, appeals and CDR's. I also maintained a workload of taking and adjudicating disability claims, sending to DDS, and if appropriate processing the SSI approval cases to payment. I maintained a fully successful performance level during these years as a claims representative.
I was responsible for answering the phones and was the front window receptionist. I had knowledge of all programs that social security administers. I would assist and refer customers as needed based on their issue. I processed and adjudicated all post entitlement changes for both SSI and RSI, I was responsible for handling Medicare Part B enrollment and withdrawals, I collected overpayment refunds etc for both titles and entered information into the computer system as needed. I maintained a workload via MDWs and PCACS computer systems. I was also responsible for the Administrative Filing and POMS filing. I did all the typing of letters for the SSI claims representatives for their SSI overpayments and determinations, I would also do their computer inputs for these cases.
I answered phones, directed calls to appropriate person if needed. I waited the front desk and set appointments if necessary. I did the administrative filing and typing. I did POMS filing. I worked on a T2 desk during this time. I set up RIB, DIB, Survivor, CCR and personal conference files, diaried them in a tub, and monitored them daily. I did typing for each claims representative in our office. I did the tele-typing for all SSA traffic including SS5's and time cards at this time as it was done. I did the supply request. I did outgoing mail everyday, gather, sort and ready for the mail carrier.
Typing
Computer programs
Answering Phones
Receptionist
Training and Mentoring
Handling Complex Cases
Social Security and SSI knowledge of programs, laws and regulations