Social Insurance Specialist

micro1 Inc.; États-Unis; À distance; USD 76 000 - 124 000; Plein temps

Résumé du poste

micro1 Inc. is seeking a Social Insurance Specialist (Contractor) to review AI-generated benefit claims and determine eligibility under retirement, survivors, disability, and related programs. You will document rationales and participate in AI training to improve model accuracy.

You will use SSA-style processes and case management systems to ensure compliance, provide feedback, and support high-quality training data for ongoing model development.

Qualifications

• Experience as a Social Insurance Specialist or equivalent with strong eligibility determination, entitlement, and evidence gathering skills.
• Familiarity with GS-0105 Social Insurance Administration or related series (GS-0996 Veterans Claims Examining, GS-0512 Internal Revenue Agent).
• Proven ability to evaluate benefit claims and apply program rules in regulated settings.
• Experience using claims processing and case management systems (SSA’s MCS, MSSICS) or similar platforms.
• Background in quality assurance for claims or similar processes within federal/state agencies.
• Ability to synthesize complex information and present informed decisions for higher level reviews.

Responsabilités

• Review and analyze AI-generated social insurance benefit claims, ensuring evidence is evaluated and guidelines are followed.
• Assess AI-generated eligibility and entitlement determinations for retirement, survivors, disability, and supplemental programs.
• Complete detailed benefit determinations and computations with clear rationales for AI training.
• Conduct quality assurance reviews of AI-generated decisions, identifying inconsistencies per policy and standards (e.g., POMS).
• Utilize claims and records systems to access, update, and manage claim files and documentation.
• Simulate higher-level review decisions, advising on reconsiderations, appeals, and over/underpayment processes.
• Deliver written and verbal feedback to improve AI model training accuracy.

Connaissances

Social insurance

Eligibility determination

Evidence gathering

Policy interpretation

Decision rationale

Outils

SSA MCS

MSSICS

GS-0105 familiarity

GS-0996 familiarity

GS-0512 familiarity

Description du poste

Role Title: Social Insurance Specialist

Role Type: Contractor

Location: United States,Remote

micro1 is engaging Social Insurance Specialists to participate in an impactful project supporting our customer's needs. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required — your domain knowledge is what matters.

Scope of Work

1. Review and analyze AI-generated social insurance benefit claims, ensuring comprehensive evaluation of evidence and adherence to established statutory and regulatory guidelines.
2. Assess AI-generated eligibility and entitlement determinations for retirement, survivors, disability, and supplemental income programs, weighing complex evidence accurately.
3. Complete detailed benefit determinations and computations, and document rationales with clarity and precision for AI training.
4. Conduct quality assurance reviews of AI-generated claims decisions, pinpointing inconsistencies or errors according to agency policy and program standards (e.g., POMS).
5. Utilize specialized claims and records systems to access, update, and manage claim files and supporting documentation.
6. Simulate higher-level review decisions, providing expertise on reconsiderations, appeals, and overpayment or underpayment processes for AI training.
7. Deliver constructive written and verbal feedback to enhance AI model training accuracy and effectiveness.

Preferred Qualifications

1. Proven expertise as a Social Insurance Specialist or equivalent, with strong experience in eligibility determination, benefit entitlement, and evidence gathering.
2. Familiarity with GS-0105: Social Insurance Administration functions, or related series such as GS-0996: Veterans Claims Examining and GS-0512: Internal Revenue Agent.
3. Demonstrated skill evaluating benefit claims and applying program rules in a regulated environment.
4. Experience using claims processing and case management systems, such as SSA’s MCS and MSSICS, or similar platforms.
5. Background in quality assurance for claims or similar processes within federal, state, or related agencies.
6. Ability to synthesize complex information and present informed decisions for higher-level review processes.