A Social Insurance Specialist is an individual responsible for making an initial review of disability determinations. Some of the responsibilities associated with the role are listed on the Social Insurance Specialist Resume as – providing research support and maintaining an orderly case record form, implementing data collection protocol in the scheduling of interviews, hiring of subjects, conducting interviews, assisting the investigator in administering the cognitive battery test and examinations for each patient, maintaining and document files and databases according to predetermined guidelines set by doctors on patient category, and assisting investigators with a blood draw specimens and preparation of laboratory equipment for analysis.
Summary of skills that can highlight a resume is – good listening skills, excellent time management and leadership skills, very good communication and writing skills, proficiency in computer skills, very good teaching capability, and good investigative and inquisitive skills. A master’s degree in Social Science is listed on eligible resumes.
Headline : Social Insurance Specialist Professional with more than three years of experience working as a Claims Representative and a Treasury Analyst. These experiences have specifically strengthened my aptitude for financial management and accounting practices, and generally honed my communication, interpersonal, and time management skills. Currently seeking a position that utilizes and strengthens these skills.
Skills : Advocacy, Proficient In Microsoft Office, Customer Service, Knowledge Of Managed Care, Working With Seniors.
Description :
Reviewed a variety of post entitlement actions taken by BAs, CAs, SRs, CRs, and CCREs.
Evaluated actions such as annual reports, enforcements, SALT, Student actions, death terminations, AERO actions, beneficiary recaps, ARF/DRC actions, REACT, and MADCAP actions.
Reviewed to identify deficiencies, anomalies, irregularities and weaknesses in the RSDI/SSI Operation process through case file reviews, and to evaluate the dollar accuracy of these findings.
Contacted beneficiaries, third parties, and other individuals by phone and by mail on many occasions.
Prepared written feedbacks on discrepancies and deficiencies, and informal feedbacks on other problems identified, but outside the scope of review.
Conducted onsite interviews with beneficiaries and other sources within the assigned areas to verify the correctness of materials and payments.
Conducted interviews we deal with beneficiaries as courteously and tactfully as possible.
Experience
5-7 Years
Level
Executive
Education
Master's In Information Systems
Social Insurance Specialist Resume
Objective : As a Social Insurance Specialist, responsible for Editing and reviewing social studies assessment items. Item types may include selected response, open-ended, performance event, and/or technology-enhanced, Ensuring that items meet WestEd writing guidelines and specifications as well as project-specific style guidelines, Editing and reviewing scoring materials associated with rubric-scored item types.
Skills : Mastery Of Microsoft Office Programs, Extensive Experience Working In Windows Operating Platforms, Microsoft Office & Outlook, Microsoft SharePoint, And Microsoft Project.
Description :
Acted as lead worker and technical expert on program policy.
Planned and conducted complex projects and had continuing activities in the development, maintenance, evaluation, and interpretation of operating policies and regulations.
Led workgroups for the analysis and development of complex policies and procedures.
Involved in the development of procedures and best practices.
Frequently facilitated regional and national meetings in an effort to document the complex business processes needed to process disability claims and to develop a vision for an improved and unified disability process.
Served as a senior analyst/recognized program expert in the Office of Disability Policy.
Planned, directed, conducted and participated in projects with continuing responsibility for major projects and broad studies pertaining to the development, evaluation, interpretation and maintenance of disability evaluation policy.
Experience
2-5 Years
Level
Executive
Education
GED
Social Insurance Specialist Resume
Summary : A motivated and educated professional with over 15 years of customer service and sales experience. Seeking a career in business with a dynamic and growing company where I will have the potential for career growth and advancement.
Skills : Linux, Windows, SQL, Python, Ruby.
Description :
Researched and analyzed policy and law in order to make and process adjudicative decisions.
Administered Social Security programs to the public.
Developed and adjudicated retirement, survivor, disability, and Medicare claims.
Investigated and resolved post-entitlement issues.
Investigated fraud and misused and made referrals to the Office of Inspector General for prosecution.
Developed and conducted continuing disability reviews and redeterminations.
Processed requests for reconsiderations and appeals.
Experience
10+ Years
Level
Senior
Education
GED
Social Insurance Specialist Resume
Objective : Highly qualified Social Insurance Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Internet, Case Management, Social Services, Community Outreach, Communication Referrals, Social Worker.
Description :
Processed and researched overpayments and debt issues.
Served as a mentor for trainees.
Planned, directed, and conducted complex studies, multifaceted projects, and continuing activities in the formulation, development, maintenance, evaluation, and interpretation of operating program policies, procedures, regulations, instructions, and court actions.
Identified potential fraud, make proper referrals and provide ongoing support to management and staff.
Protected the privacy of all customers by adhering to security and disclosure guidelines.
Recommended modifications in the procedure, policy, or systems, and advise senior management of significant problem areas and/or trends in types of errors/ issues encountered during the claims adjudication process.
Analyzed, located, and researched policy, procedures, documents, records, and systems capabilities efficiently and effectively to make claims decisions, to ensure proper referral of documents, and to respond to inquiries.
Experience
2-5 Years
Level
Junior
Education
High School Diploma
Social Insurance Specialist Resume
Headline : Looking for an opportunity to utilize excellent customer service, written and verbal communication skills in order to provide information to individuals regarding the various benefits and programs available More than 10 years of combined customer service and sales experience in a variety of settings, including hospitality, telecommunications, and post-secondary education recruitment.
Skills : Professionalism, Hard work, and Quick-learner.
Description :
Conducted initial interviews with aged 62 years and older for retirement.
Conducted interviews for disabled individuals, disabled children, and blind for benefits under both Social Security Disability program and Supplemental Security Income.
Interviewed include verification of income and resources, and medical queries to determine program eligibility, ensured status.
Conducted periodical follow-up reviews for claimants who are currently on benefits to determine eligibility to continue benefits for continued medical reconsiderations.
Screened walk-in claimants and provide assistance with account information where necessary.
Scheduled appointments and VIP to meet with new and existing claimants.
Utilized WAC to process internet appeals for reconsideration and hearing requests.
Experience
5-7 Years
Level
Executive
Education
BA In Business Administration
Social Insurance Specialist Resume
Summary : Resourceful and experienced bilingual professional with initiative and excellent verbal and written communication skills in both English and Spanish. Mature critical thinker with extensive international experience comfortable being a team player in a fast-changing environment.
Skills : Well-developed Problem Solving Abilities, Strong Organizational Aptitude. Capacity To Interact With Other Professionals, Managers, And Staff Levels. Mac 0SX, Microsoft Office XP, Microsoft Office 2000, Adobe Illustrator, PeopleSoft. NY Real Estate License.
Description :
Conducted interviews to obtain, clarify, and verify information about initial and continuing eligibility for retirement, survivors, disability, and health insurance benefits, and eligibility for supplemental security income including State supplements.
Adjudicated and authorized retirement and health insurance claims evaluating evidence and developing all factual and legal issues.
Made final determinations subject only to the claimant's rights to reconsideration or appeal.
Reviewed cases to reconsider decisions affecting an individual's eligibility or amount of benefit.
Identified and investigated questionable situations involving entitlement, continuing benefit, or improper use of Social Security numbers to decide whether fraud prosecution should be recommended.
Studied program operations, new legislation, automated systems, management initiatives, and operation of interacting programs and organizations to develop new and modified operating instructions and training material.
Routinely contacted employees in various parts of the agency claimants, recipients, and beneficiaries and their representatives, employers in all sectors of the economy; Federal, State, and local government employees; physicians, attorneys, and others as required for a general exchange of information in order to resolve entitlement and benefits matters.
Experience
7-10 Years
Level
Management
Education
Bachelor Of Arts
Social Insurance Specialist Resume
Summary : Results-Oriented Social Insurance Specialist Professional with years of solid Civil Service experience In employee benefits, human resources services, training, and small business ownership. Polished professional with a proven track record of success in operations, vendor, and community relations. Expertise in Federal and State disability and workers compensation laws, mentoring, and case management.
Skills : Social Insurance, Planning Skills.
Description :
Conducted interviews in English and Spanish, to obtain information for client initial claim and continuing eligibility for Social Security disability and Supplemental Security Income.
Adjudicated claims and authorize payment for benefits for all programs administered by the Social Security Administration.
Processed 80 initial and post entitlement claims a month.
Evaluated evidence and the facts of situations, to draw sound conclusions and explain the basis for the conclusions.
Understood the philosophies, principles, and objectives of social insurance and welfare programs.
Knowledged of the policies and specific provisions of disability, health insurance programs, and SSI programs.
Received numerous letters of recommendation from clients for Outstanding Customer Relations.
Experience
7-10 Years
Level
Management
Education
BA In Business Administration
Social Insurance Specialist Resume
Summary : Talented and results-oriented Social Insurance Specialist professional with a background in diverse areas of Insurance products, sales initiatives, marketing, project management, and relationship management. Skilled in identifying performance drivers, implementing process improvements, and streamlining daily objectives.
Skills : Microsoft Office, Lectora, Adobe Flash, Camtasia.
Description :
Reviewed and authorized claims and other complex entitlement determinations for benefits under Titles 2 and 16 of the Social Security Act.
Made conclusive administration determinations subject only to the claimant's right to reconsideration and/or appeal.
Independently reviewed, adjudicated, and authorized claims for monthly benefits, entitlement to HI/SMI benefits, and/or Income Related Monthly Adjustment Amounts.
Conducted initial review of Administrative Law Judge (ALJ) disability case reversals.
Completed development and evaluation of all facts and evidence.
Reviewed material forwarded from the District Office (DO).
Determined issues in any claim or referred post-adjudicative action Prepare formal or informal determinations relating the facts, evidence, and issues to the requirements of the Social Security Act and policies including appropriate precedent cases.
Experience
7-10 Years
Level
Management
Education
Master Of Education
Social Insurance Specialist Resume
Headline : Seeking a Social Insurance Specialist position with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Planning Skills, Organizational Skills.
Description :
Conducted high-quality interviews to effectively determine customer needs.
Utilized automation tools and technology in accomplishing assigned work.
Independently gathered information, make determinations, and adjudicate initial claims and/or post-entitlement workloads to meet customer and agency expectations.
Initiate requests for development at the earliest point and make timely follow-ups on all pending workloads.
Conducted personal conferences and on-site representative payee reviews.
Contributed to a learning environment by conducting training and mentoring other employees.
Acted as a liaison to community organizations and agencies.
Experience
5-7 Years
Level
Executive
Education
MS
Social Insurance Specialist Resume
Summary : A self-starter and a quick learner. Versatile skill set with experience in public service, sales, and written and oral communication. Demonstrated ability to multitask and get things done timely and consistently. Highly motivated with the ability to work well with people.
Skills : Microsoft Word, Managing Skills.
Description :
Interacted with clients to provide and obtain information regarding retirement/disability claims.
Processed claims for denial/payments.
Interpreted SSA laws and regulations, weighed medical evidence, made presumptive decisions, processed appeals.
Performed post-entitlement work consisting of overpayments, released underpayments, and determined continuing eligibility and other workloads.
Had the opportunity to work with various groups of people, interacting with them and offering assistance any way I could.
Used Exceptional oral and written communication skills, analytical thinking and decision making, adaptability, and patience.
Conducted case reviews by informal and formal conferences, to reconsider initial and post eligibility decisions affecting eligibility and or amount of payment under the Supplemental Security Income program.
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