Claims Examiner

Calculated Hire; Indianapolis (IN); On-site; USD 55,000 - 75,000; Full time

Job summary

Calculated Hire is seeking a skilled Claims Investigator to coordinate and determine unemployment eligibility in compliance with federal and state requirements. You will perform fact-finding, legal analysis, and issue final written determinations regarding entitlement or denial of benefits.

The role involves communicating laws and requirements to claimants and employers, investigating claims, managing correspondence, supporting appeals and hearings, and ensuring timely processing within

Qualifications

• Interpret and apply technical manuals, memoranda, written guidelines, statutes, regulations, and policies related to unemployment compensation.
• 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 laws, regulations, policies, and procedures to determine eligibility.
• Excellent verbal and written communication, including explaining statutes and regulations clearly.
• Professionalism and tact when interacting with stakeholders.
• Ability to work independently while following supervision and procedures.
• Ability to manage high-volume workload and meet deadlines.
• Ability to travel on a limited basis when required.

Responsibilities

• Coordinate with claimants, employers, and agency staff to make senior-level eligibility determinations through objective fact-finding and legal analysis.
• Explain unemployment laws, procedures, programs, and eligibility requirements to claimants and employers.
• Interview claimants and employers regarding employment history and factors affecting benefit eligibility.
• Make final written determinations regarding entitlement to or denial of benefits.
• Collect information and forward to Central Office for monetary determinations.
• Respond to correspondence from claimants and employers regarding unemployment claims.
• Investigate issues such as stolen, lost, destroyed, or forged benefit warrants.
• Assist with filing appeal forms for protested claims.
• Provide testimony at referee hearings.
• Organize and prioritize workload to meet federal processing standards.
• Complete daily activity summaries of claims processed and characteristics.
• Navigate multiple computer systems and stay updated on procedures.
• Investigate and correct system error lists involving wage reporting and benefit payments.
• Support the Uplink customer service call center during high volume periods.
• Ensure determinations are completed accurately within federal timeframes.
• Take new and continued unemployment claims as needed.
• Resolve field issues as directed by the Claims Investigator Supervisor.
• Perform other related duties as assigned.

Skills

Computer skills

Verbal communication

Written communication

Decision making

Technical interpretation

Travel ability

Job description

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.