05/01/1987 07403

CLAIMS INVESTIGATION AGENT SUPERVISOR

DEFINITION:

This is professional and supervisory work in the investigation and settlement of claims, and the recovery of erroneously provided public assistance benefits and services.

An employee in this class supervises lower level agents engaged in claims investigation, settlement and recovery work in the child support enforcement, reimbursement and restitution program activities of the Department of Public Welfare. Work involves interpreting and applying the governing Federal and state mandates, policies and procedures applicable to the type of claim and specific program area; and assigning work, providing technical guidance and supervision and evaluating work performed. Work includes reviewing claims referrals and directing the collection and analysis of information for determining the feasibility for investigating, locating, encumbering and obtaining resources for the prosecution and settlement of claims against present and former public assistance clients, legally responsible individuals or organizations providing contracted services to welfare program clients, and the establishment of paternity and enforcement of child support orders for individuals responsible for dependent public assistance clients. Work also includes directing the coordination of program activities with other agencies such as the Internal Revenue Service, Social Security Administration, Bureau of Employment Security, Bureau of Motor Vehicles, and county judiciary and Domestic Relations Services. The work is performed with independent judgment in accordance with mandates, policies and procedures, but requires discretion and judgment in the directing the conduct of investigations, making decisions and implementing reimbursement, restitution, child support enforcement or prosecution actions. Work is performed under the general direction of a Claims Investigation Manager through conferences, reports and results achieved in meeting established goals and objectives.

EXAMPLES OF WORK:

Supervises lower level agents engaged in claims investigation, settlement and recovery work in the child support enforcement, reimbursement and restitution program activities for the Department of Public Welfare.

Supervises and may participate in conducting investigations and settling claims, recovering erroneously provided public welfare benefits and services, assembling and presenting information for use in prosecution for fraud; and enforcing the provision of state and Federal Child Support Laws.

Provides guidance and assistance to lower level agents in cooperating with domestic relations office personnel in establishing paternity and enforcing child support orders for responsible individuals and parents of dependent public assistance clients.

Directs lower level agents in applying the governing Federal and state mandates, policies and procedures applicable to the specific program and searching appropriate local courthouse records, county assistance office files and financial records of public assistance clients.

Supervises the review of claims referrals, the collection and analysis of information on individual claims and the establishment of paternity and enforcement of child support orders for individuals responsible for dependent public assistance clients.

Supervises appraisals of real estate and negotiations for the sale and rental of property, the submission of bids at judicial sales of property and makes recommendations in compromise settlements.

Provides training for lower level agents and agent trainees in the techniques of negotiation and the settlement of restitution and reimbursement claims and in the establishment, enforcement and collection of child support orders.

Assists in developing methods, systems and procedures for establishing and settling claims.

Schedules work of lower level employees and evaluates their work performance through results achieved in meeting established goals and objectives.

Interprets claim settlement work to public officials and other individuals and aids in establishing and maintaining satisfactory working arrangements with governmental and other agencies.

Prepares correspondence, reports and recommendations on the settlement of claims.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES:

Knowledge of Federal and state regulations and departmental policies and procedures governing the child support enforcement, reimbursement and restitution programs activities.

Knowledge of the techniques and methods of investigation and the legal procedures involved in conducting investigations including rules of evidence for prosecution of fraud cases.

Knowledge of the organization and functions of local courts, county domestic relations offices and county assistance offices.

Knowledge of the laws pertaining to conveying and encumbering real estate, prosecuting for fraud, administering estates and individuals obligation for the support of legal dependents to ensure all activities taken are legally defensible.

Knowledge of the procedures and techniques for initiating action to locate legally responsible individuals and parents of dependent public assistance clients.

Knowledge of the principles and practices of supervision and office management.

Knowledge of the methods and techniques of interviewing.

Knowledge of individual and group behavior.

Knowledge of current social and economic conditions which impact upon debtors, in order to make informed decisions on claim settlement issues.

Knowledge of the functions and objectives of the various public assistance and claims settlement programs in order to train subordinate staff and evaluate recommendations.

Knowledge of the methods and techniques required to conduct investigations and collect, review and evaluate claims settlement data.

Knowledge of the functioning of the Parent Locator Service and the procedures necessary to initiate action to locate missing legally responsible individuals and parents of public assistance clients.

Knowledge of interviewing practices and techniques.

Ability to plan, organize, supervise and evaluate the work performance of subordinates.

Ability to exercise judgment in evaluating situations and recommendations and in making decisions.

Ability to establish and maintain effective working relationships with associates, debtors, lawyers, county assistance offices, domestic relations offices, courts, public officials and others.

Ability to express ideas clearly and concisely, orally and in writing, in order to communicate information to subordinate staff and business contacts.

MINIMUM EXPERIENCE AND TRAINING:

One year as a Claims Investigation Agent 2;

or

Seven years of experience in investigative public contact experience requiring the review and presentation of records, correspondence and documents used in the prosecution of cases, approval of claims or credit, or collection of debts, two years of which must have been in a Department of Public Welfare claims investigation program;

or

Any equivalent combination of experience and training.

A bachelor's degree in Pre-law, Criminal Justice, Police Science, or a closely related field may be substituted for up to four years of the required general experience.