Claims InvestigatorPosition Summary
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 regulations. This role requires objective fact-finding, legal analysis, and the ability to clearly explain unemployment laws, policies, and procedures to claimants and employers. The Claims Investigator will conduct detailed investigations, issue written determinations, support appeals, provide hearing testimony, resolve system-related issues, and assist customer service operations during high-volume periods. The ideal candidate possesses strong analytical abilities, specialized knowledge of unemployment insurance laws, exceptional organizational skills, and the professionalism needed to manage sensitive situations effectively.
Key Responsibilities
- Conduct objective fact-finding investigations and legal analysis to make senior-level eligibility determinations for unemployment claims in accordance with federal and state requirements.
- Communicate unemployment laws, procedures, benefit rights, and eligibility requirements to claimants and employers.
- Interview claimants and employers to obtain and verify employment history, separation details, and other relevant information.
- Prepare and issue final written determinations regarding entitlement to or denial of unemployment benefits.
- Compile claim information from claimants, employers, and internal audit teams and forward documentation for monetary determinations.
- Receive, investigate, and respond to correspondence from claimants and employers regarding unemployment claims.
- Investigate cases involving stolen, lost, destroyed, forged, or otherwise disputed benefit warrants.
- Assist claimants and employers with filing appeals related to protested claims.
- Provide testimony and supporting documentation during referee and appeal hearings.
- Organize and prioritize a high-volume workload while meeting strict federal timeliness and quality standards.
- Complete daily activity reports detailing claims processed and claimant characteristics.
- Utilize multiple computer systems effectively while adapting to ongoing system updates and process changes.
- Investigate and resolve system errors related to wage reporting, claim calculations, and benefit payments.
- Support the Uplink customer service call center during periods of increased call volume.
- Process new and continued unemployment claims as needed.
- Resolve field issues affecting unemployment insurance operations under the direction of the Claims Investigator Supervisor.
- Perform additional duties and special projects as assigned.
Required Qualifications
- Ability to interpret and apply technical manuals, memoranda, policies, and written guidelines related to unemployment compensation laws and regulations.
- Working knowledge of labor market conditions, including seasonal employment trends, layoffs, and labor disputes.
- Strong computer proficiency and the ability to quickly learn and adapt to new technologies and systems.
- Excellent analytical, decision-making, organizational, and prioritization skills.
- Ability to communicate complex statutes, regulations, policies, and procedures clearly and professionally to claimants, employers, agency staff, and stakeholders.
- Demonstrated professionalism, diplomacy, and tact when handling sensitive or challenging situations.
- Ability to work independently while following established protocols and supervisory direction.
- Strong attention to detail and commitment to accuracy in investigations and determinations.
- Ability to manage multiple priorities while consistently meeting deadlines and performance standards.
- Willingness and ability to travel on a limited basis as required.
Preferred Qualifications
- Experience in unemployment insurance, claims adjudication, benefits administration, workforce development, labor relations, investigations, compliance, or a related field.
- Knowledge of federal and state unemployment insurance programs and regulations.
- Experience conducting interviews, investigations, case reviews, or administrative hearings.
- Experience preparing detailed written findings, determinations, or legal documentation.
Pay: $20.00 per hour
Work Location: In person
