Claims Examiner

Our client is seeking a skilled Claims Investigator to coordinate and make senior-level eligibility determinations for unemployment claims while ensuring compliance with stringent federal and state requirements. This role is responsible for objective fact-finding, legal analysis, and making final written determinations regarding entitlement to or denial of unemployment benefits. The Claims Investigator will communicate unemployment laws, policies, procedures, and benefit eligibility requirements to claimants and employers; investigate employment history and benefit issues; manage claim-related correspondence; support appeals and hearings; resolve system errors; and provide customer service support during high-volume periods. The ideal candidate will have strong knowledge of unemployment compensation laws, excellent analytical and decision-making abilities, strong computer skills, and the ability to interpret technical guidelines and communicate complex regulations clearly. The position requires professionalism, tact, organization, and the ability to manage a high-volume workload while meeting strict federal and state deadlines. Key Responsibilities Coordinate with claimants, employers, and agency staff to make senior-level eligibility determinations through objective fact-finding and legal analysis while meeting federal and state timeliness and quality standards. Explain unemployment compensation laws, procedures, programs, benefit rights, and eligibility requirements to claimants and employers. Interview and question claimants and employers regarding employment history, separation information, and other factors affecting benefit eligibility. Make final written determinations regarding entitlement to or denial of benefits. Compile information from claimants, employers, and the Audit Section and forward required information to the Central Office for monetary determinations. Receive, investigate, and respond to correspondence from claimants and employers regarding unemployment claims. Conduct investigations involving stolen, lost, destroyed, or forged benefit warrants. Assist claimants and employers with filing appeal forms for protested claims. Provide testimony and supporting information at referee hearings. Organize and prioritize a heavy workload to ensure compliance with stringent federal processing standards. Complete daily activity summaries documenting the types and volume of claims processed and relevant claimant characteristics. Navigate multiple computer systems efficiently and stay current with system updates and procedural changes. Investigate and correct system error lists involving wage reporting, claim calculations, and benefit payments. Support and provide backup for the Uplink customer service call center during periods of high volume. Ensure benefit determinations are completed accurately and within required federal timeframes. Take new and continued unemployment claims as needed. Resolve field issues affecting unemployment insurance operations as directed by the Claims Investigator Supervisor. Perform other related duties as assigned. Required Qualifications Ability to interpret and apply technical manuals, memoranda, written guidelines, statutes, regulations, and policies related to unemployment compensation. Working knowledge of labor market dynamics, including seasonal layoffs and labor disputes. Strong computer skills with the ability to quickly learn new technologies and incorporate them into daily workflows. Strong decision-making, organizational, prioritization, and problem-solving skills. Ability to analyze facts and apply applicable laws, regulations, policies, and procedures to make accurate eligibility determinations. Excellent verbal and written communication skills, including the ability to clearly explain statutes, regulations, policies, and procedures. Demonstrated professionalism and tact when interacting with agency staff, claimants, employers, and other stakeholders. Ability to work independently while accepting supervision and adhering to established protocols. Ability to manage a high-volume workload while maintaining accuracy and meeting strict deadlines. Ability to travel on a limited basis when required. #J-18808-Ljbffr