JOB TITLE: UNEMPLOYMENT COMPENSATION QUALITY ASSURANCE SPECIALIST

JOB CODE: 06640

DEFINITION: This is advanced technical work in the review and evaluation of unemployment compensation benefits claims determinations for adherence to federal and state regulations.

An employee in this job is responsible for conducting quality reviews of non-monetary claims determinations in accordance with federal benefits timeliness and quality standards and state laws, regulations, and policies as a part of a central office quality assurance unit. Work involves evaluating a sample of claims determinations by reviewing claim documentation and records, analyzing findings of fact and outcomes, and determining the overall quality rating of the claim determination. An important aspect of this work involves identifying error trends and opportunities for improvement, recommending training and policy revisions, and collaborating with unemployment compensation management on efforts to improve the overall quality and timeliness of claims determinations. Work also includes providing guidance and instruction to unemployment compensation service center supervisory and managerial staff on claims determination evaluation standards and practices. Work is assigned by an administrative supervisor and is reviewed for adherence to established objectives and program effectiveness.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.):

• Reviews a sample of non-monetary claims determinations using federal measurement criteria and state laws, regulations, and policies to ensure benefits timeliness, quality, and consistency throughout the unemployment compensation service centers.

• Conducts a thorough evaluation of the claim record, documentation, findings of fact, rebuttal, and correspondence to score the quality of the claim determination.

• Reviews and analyzes claims determinations to identify error trends across unemployment compensation service centers.

• Collaborates with unemployment compensation training staff to develop or update trainings as necessary to address issues found during claims determination evaluation.

• Recommends new or revised policies and procedures to address recurring issues identified in claims determination evaluation.

• Conducts individual or group trainings with unemployment compensation service center staff on benefits timeliness and quality standards.

• Reviews claim determination evaluation results with the appropriate unemployment compensation supervisory and managerial staff.

• Conducts second level review of benefits timeliness and quality reviews conducted by field staff.

• Provides feedback to field staff on the accuracy of field timeliness and quality reviews and provides interpretation of scoring standards when necessary.

• Prepares statistical analyses and reports of benefits timeliness and quality review findings.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of unemployment compensation laws, regulations, and guidance.

• Knowledge of the functions and operations of unemployment compensation service centers.

• Knowledge of unemployment compensation claims processing and adjudication practices.

• Knowledge of interviewing techniques required to gather information.

• Ability to read and interpret policies and procedures.

• Ability to analyze and interpret data.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities):

• One year of experience as an Unemployment Compensation Operations Examiner;

or

• Three years of experience as an Unemployment Compensation Claims Examiner;

or

• Three years of experience performing technical work in an unemployment compensation program.