Unemployment Claims Examiner 11- Unemployment Claims Manager
State of Michigan
- Assigned workloads to unemployment examiner staff and provided constructive feedback to ensure optimal performance.
- Oversaw the operations of Unemployment Insurance Offices off-site location, ensuring all activities were carried out in accordance with established methods and procedures.
- Managed a high volume of unemployment claims while maintaining a high level of accuracy and attention to detail. Developed and implemented new procedures to streamline the claims process and reduce wait times and meet deadlines.
- Effectively communicated with claimants, employers, and other interested parties via telephone, mail, fax, and electronic methods to determine eligibility for unemployment benefits and/or resolve unemployment claims issues. Provided clear and concise instructions to staff and ensured they were able to interpret complex claims issues and determine proper course of action.
- Prepared detailed reports outlining all pertinent case information used in making decisions regarding payment of benefits.
- Reviewed and analyzed claims to ensure accuracy of information, completeness of medical records, and compliance with policy terms.
- Determined if claims were valid according to established rules and regulations.
- Analyzed trends in denied claims identifying patterns which could be addressed through process improvement initiatives.
- Carefully analyzed and collected evidence to support contested claims in court.
- Interacted professionally with customers providing clear explanations for decisions made regarding their claims.
- Conducted interviews with claimants, employers, physicians and other healthcare providers to obtain additional information relevant to the claim.
- Ensured that all required notifications were sent out promptly following decisions on claims.
- Resolved customer inquiries regarding claims status in a timely manner.
- Researched complex issues related to specific cases involving multiple parties or unusual circumstances.
- Compiled evidence from various sources such as medical records, employment histories, and legal documents.
- Evaluated eligibility for benefits based on analysis of case facts and application of applicable laws.
- Tracked exhibits admitted during court hearings and updated documentation.
- Participated in training sessions designed to update staff on changes in laws governing insurance policies.
- Performed quality assurance reviews on completed claims ensuring accuracy of documentation.
- Provided technical guidance and advice to management concerning claim adjudication processes and procedures.
- Recommended appropriate actions based on review findings including denial or approval of benefits payments.
