Claim Processing



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Branch Information

Sacramento, CA - (USA) 1740 Arden Way Suite 3 CA Sacramento , CA 95815 Phone : 916-925-5100



Job Description

Job Title: Fact Finding Agent - Claim Processing

Note: This position will work full-time, Remote, Monday through Friday 8am to 5pm Pacific Time.

Rate: $20/hour

Job Summary

The Fact Finding Agent is responsible for reviewing unemployment insurance claims with outstanding issues to determine next steps required to resolve those issues. Using critical thinking skills, the Agent will analyze all information, notes, and documentation to identify gaps or discrepancies in information. They will then perform outreach to claimants and/or employers to obtain the necessary information, notate that in the claim file, and forward detailed notes as required to resolve the issue.

The position requires using time management to work a caseload effectively and in order of priority set by leadership, critical thinking skills to identify the needs on each unique claim, and communication skills ensuring that information gathered is clearly notated in the claim.

Job Duties

Fact Finding Agents will perform job duties such as:

* Analyzing claim information to determine the cause of outstanding issues

* Assessing eligibility requirements based on UI Code, Policies, and Procedures

* Evaluating wage and earnings

* Communicating with claimants and employers by phone to obtain missing information

* Working closely with subject matter experts to gain further understanding of unique issues and how to address them

* Referring more complex issues to supervisor or tenured staff

* Notating all contacts and actions taken on a claim clearly and thoroughly

* Demonstrating the ability to make timeline and logical decisions

* All other duties as assigned by management to support claim processing

Experience & Qualifications

* Bachelor's degree preferred

* 1-2 years' experience in claim or case management

* Proficient technical writing skills to support detailed case notes

* Critical thinking & time management skills