Walter M Potts

As a Title 16 Claims Specialist, I provide a full range of assistance to individuals regarding all programs administered by the Social Security Administration. My duties include but are not limited to the following:

• Adjudicate both Initial Claims and post-entitlement (PE) issues

• Complete knowledge of and understanding of all SSA automation systems such as Modernized Supplemental Security Income Claims System (MSSICS), Representative Payee System (RPS), Prisoner Update Processing System (PUPS), and Modernized Claims System (MCS) allowed me to effectively clear SSI issues

• Use of Workload Management System (WMS), Initial Claims Query System (ICQS), and MSSICS enabled me to process claims in a timely, organized fashion

• Use of Post Entitlement Operational Data Store (PEODS), MSSICS, and STARZ & STRIPES allowed for effective adjudication in post-entitlement cases

• Gathered information from beneficiaries, representative payees, and attorneys in order to reconcile and document cases to clear discrepancies

• Analyze pertinent data such as bank account statements, pay stubs, life insurance policies, and legal documents to determine SSI eligibility based on income and resources

• Refer beneficiaries to file for other benefits such as food stamps, Medicaid, Veterans benefits, worker’s compensation, and unemployment

• Compute attorney and non-attorney fees, as well as completing SSI windfall offset computations in concurrent eligibility situations

• Make determinations based on SSA laws and regulations and how they are applied through the SSI program

• Knowledge of federal and state law enabled me to process cases through date inputs and SSA data processing systems

• Recognize and resolved systems inputs, alerts, and diaries to process discrepancies

• Collect data from penal institutions, bureau of unemployment, and various employers to detect the potential for fraud or non-reporting of income for SSI purposes.

• Assist office personnel with automation issues such as logging on to mainframe, printer problems, SSA toolbar, and PCOM

• Conduct telephone and face-to-face interviews with beneficiaries, representative payees, and legal representatives and provided them with payment and eligibility status relating to SSI guidelines

• I use the Distributed Online Correspondence System (DOCS) to notify beneficiaries and representatives of current payment status, initial eligibility, and changes in payment.

• Assist attorneys with claims by gathering documents necessary to ensure, if approved, they would receive their proper payments in a timely manner.

• Utilize the SSA automated system to file all documents provided by claimants and/or their representative

• Work fraud cases by gathering documents and information necessary to ensure that all cases being reviewed for misuse of funds or misinformation was processed in accordance to the SSA laws and regulations. If fraud is involved, refer the case to the Office of Investigator General (OIG) for further investigation.

• Utilize all automated systems such as Workload Action Center (WAC), Modernized Supplemental Security Income Claims System (MSSICS), and Electronic Disability Case Selection (EDCS), Web Ace and Work Track to process claim timely.

• Assist the Disability Determination Services (DDS) by collection necessary data needed to review cases

• Gather information from banks, employers, child support services and bureau of unemployment to unsure that claimant received accurate payments.

• Research our policies whenever in doubt that proper procedures were being followed or to ensure that proper procedures were being followed.

• Review and release payments for cases with an underpayment on the record.

• Process appeals for cases that were medically denied.

• Assist the office by making sure to keep an eye on Visitors Intake Process (VIP) to assist the walk-in traffic whenever the Service Representatives in our office needed our assistance servicing the public.

• Assist co-workers with workload whenever they fell behind with their duties by teaching them how to use all the available tools provided by the agency to process their claims timely and by helping organize their work.

Maintaining the office WebALJ and Web Recon listings.

Selected as the Fraud, waste and abuse representative for the SSI unit.

· Acted as one of three Inspector Gadgets for the office. Training staff on the importance of reporting fraud, waste and abuse.

· I was selected by management to serve on the internet unit. Processing I-Claims, I-Appeals and attorney documentation.

· Work on the Skills Connect cadre to improve various workloads for the North Florida Region (NFL).

As a Customer Service Representative, I provided a full range of assistance to individuals regarding all programs administered by the Social Security Administration. My duties are as follows:

• Interviewing potential claimants for Social Security Retirement benefits by assessing his/her eligibility for benefits on their record and/or current or former spouses, minor children who may be eligible, as well as disabled adult child(ren) of the claimant.

• Interviewed potential claimants for widow(er) benefits. Reviewing their marriage history and consult them regarding the most advantageous benefits to apply for.

• Interviewed potential claimants for disability and/or supplemental security income benefits. Pulling the SEQY data in order to access their work history to establish their date last insured status. This is done to ensure the claimants file for the proper benefit(s). If eligible for supplemental security benefits I evaluate income and resources if any. Gathered pertinent information such as date of onset; assisting claimants with filing online disability applications, completing the proper forms and releases and scheduling appointments to file; fax medical evidence of disability claims into the electronic folder for viewing by the Disability Decision Board such as medical evidence, consents for release of information, adult and child disability reports, reconsiderations and ALJ requests, etc.

• Interviewed potential Medicare recipients by assessing their eligibility based on age or disability benefits. I consult claimants regarding their month of entitlement, initial enrollment period and if they qualify for special enrollment or general enrollment period; answer questions concerning Medicare Part C and B; assist beneficiaries with Medicare Savings Programs and help file appeals for IRMAA issues.

• Processed social security card applications for foreign and domestic born applicants; also for individuals filing for a social security number for the first time; evaluate evidence of lawful presence by accessing SAVE query as well as for potential fraud; processing replacement applications for name change applications due to marriage or adoption; make proper changes to incorrect date of birth inputs on the NUMIDENT AND MBR by following policy procedures. Proper policy procedures include ordering reprints of previous applications, querying EVVE to check the validity of the birth certificate submitted by the number holder and following SSA policy and procedure step by step. Documented my rationale for all inputs made. Assisting claimants who do not have proper identification for a replacement social security card with what is needed to obtain identification.

• Processed mail timely to prevent loss of benefits such as wages, address changes and direct deposit changes.

• Assisted Title 2 and Title 16 beneficiaries with requests for benefit verifications, changes of address and phone numbers, voluntary tax withholdings, changes of representative payees (includes applications for change of payee to a relative, organization or direct payment, representative payee accounting, and cases of payee misuse), placed individuals back into pay after periods of incarceration as well as suspended benefits of claimants who are currently incarcerated.

• Obtained evidence of fraud, waste and abuse of benefits; make critical decisions regarding proper payee changes; cases to the Office of Inspector General when allegations of fraud are found.

• Maintained the offices DACUS (Death Alert Tracking System) listing to ensure benefits are terminated when a beneficiary is deceased for Title 2 and Title 16 benefits. Identifying possible leads for surviving spouses and minor children who may be eligible for benefits; scheduling appointments for such eligibility as well as for lump sum death payments. Located two cases of death benefit fraud that were referred for prosecution. One case involved in Operation Tombstone in 2014. Both cases totaling over $150,000.00 in loss of Social Security benefits.

• Processed overpayments caused by claimant’s employment earnings, spouses or parent’s employment earnings, living arrangements and incarcerations; assisting with filing waivers and reconsiderations for Title 2 and Title 16 overpayments; interviewing overpaid claimants and documenting my findings on the SSA-632SUP form

(I also have experience writing waiver determinations); forwarding timely filed appeals to the appropriate payment center when necessary via paperless file and documenting my actions in Debt Management System.

• Maintained and processing the office 2.8 (Earnings Discrepancy) listing by gathering evidence of earnings from individuals who do not earnings for particular years of work posted to their SEQY record. This evidence includes W2 forms and timely filed tax returns.

• Maintained the PUPS (Prisoner Alert Tracking System) listing according to my assigned alphabet; querying numerous county jail websites as well as state and federal prisons all over the United States in order to locate beneficiaries that may be incarcerated and still receiving the social security payments; suspending benefits when required to prevent overpayments.

• Maintained MDW listing according to my assigned alphabet. These requests are for various reasons such as address changes, direct deposit changes, status of claims, living arrangement changes, reports of possible fraud, waste and abuse, inquiries of overpayments, etc.

• Remained acquainted with policy and procedural changes within SSA.

• Served the public in a professional and knowledgeable manner.

• Conducted office training on the UBIDUO machines for deaf claimants. Trained staff how to use the equipment when a hearing impaired claimant wishes to communicate in that chosen manner.