JOB TITLE: UNEMPLOYMENT COMPENSATION OPERATIONS EXAMINER

JOB CODE: 06650

SERIES NATURE OF WORK: The Unemployment Compensation Operations Examiner job series describes work evaluating unemployment compensation benefits claims as required by the federal benefits accuracy measurement program.

DEFINITION: This is specialized technical work in examining, analyzing, and evaluating claims for unemployment compensation benefits to determine the accuracy of payments for paid claims and the accuracy of disqualifications for denied claims.

An employee in this job is responsible for reconstructing a sample of paid and denied claims for unemployment compensation benefits; analyzing and validating claim records and information; ensuring compliance with federal and state laws, regulations, and policies; and determining the accuracy of the benefit amount paid or benefits denied. Work involves interviewing claimants, employers, and other interested parties to gather and develop the facts of the case and ensure the accuracy of the information used in the claim. Work includes documenting findings, determining the appropriate payment amount, identifying any errors or issues that require further action, and completing mandated reporting requirements. Work is performed independently within a dedicated benefits accuracy measurement unit. Work is reviewed for soundness of judgment and adherence to federal and state laws, regulations, and policies by an Unemployment Compensation Operations Examiner Supervisor through a review of findings and reports.

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.):

• Examines and evaluates a sample of claims for unemployment compensation benefits to determine the accuracy of the benefit amount paid on the claim.

• Examines and evaluates a sample of denied determinations to determine the accuracy of the denial.

• Interviews claimants, employers, eye witnesses, and interested third parties to develop the claim facts and verify information used in the claim including the circumstances surrounding the claimant’s unemployment.

• Validates with employers that claimants’ wages are accurately reported.

• Analyzes financial records to determine employee earnings, identify employer tax liabilities, and detect fraudulent activity.

• Contacts other government agencies, including other states, to obtain relevant claims data.

• Prepares reports of findings, documents any over or under payments, and identifies the party at fault for the over or under payment.

• Develops recommendations to resolve incorrect claims.

• Gathers information through phone calls, fax, and mail.

• Attends unemployment compensation hearings as needed.

• Composes case summaries of investigations based on the analysis of completed case data and transfers the case information to a coded format for input.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

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

• 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 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):

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

or

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