Army Installation Management Command Senior Claims Specialist NF-05 in Fort Sam Houston, Texas
It is the applicant's responsibility to read all sections and associated links in this vacancy announcement.
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Responsible for reviewing insurance claims after they are submitted to make sure that proper filing procedures have been followed, to determine whether or not they are covered under a policy, and to evaluate the extent of a settlement that the Army Central Insurance Fund (ACIF) must pay.
Ensure claims adjusters and commercial insurance policy providers are in compliance with the Army Regulation AR 215-1, the Longshore and Harbor Workers' Compensation Act, applicable insurance policy, and the claims service contract. May assist the Chief Banking, Investments, and Insurance in representing the Army at claim disputes conferences and hearings before Department of Labor District Commissioners and Administrative Law Judges, and in developing and presenting educational seminars/workshops for employees, supervisors and managers.
Investigates, analyzes, and determines the extent of ACIF's liability concerning personal, casualty, or property loss or damages, and attempts to effect settlement with claimants. Reviews Workers' Compensation claims to determine that payments and settlements are made in accordance with the Longshore and Harbor Workers' Compensation Act, and acts as alternate Contracting Officer's Representative (COR) for the claims service contract. May calculate benefits, pay and process claims within designated authority level. Verifies and reimburses the unemployment compensation claims.
Must ensure that the costs of a particular treatment are reasonable depending on the diagnosis a patient received by reviewing police reports, medical treatment records, medical bills, expected hospital stay and disability time or physical property damage to determine the extent of liability. Depending on his findings, he/she may suggest approval or denial of claims to the Chief Banking, Investments and Insurance for consideration.
Other duties of the Senior Claims Specialists include examining, adjudicating and authorizing payments on claims; auditing claim payment; adjusting reserves to ensure that reserve activities are consistent with the claims service contractor's assessment and the actuary recommendations; ensuring timely disbursement of funds to clients; investigating and assessing damage to property and creating or reviewing property damage estimates; identifying claims with possible recovery from third parties; interviewing or corresponding with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review; analyzing information gathered by investigation and report findings and recommendations; negotiating claim settlements and recommending litigation when settlement cannot be negotiated.
Occasional travel - You may be expected to travel for this position.
- #### Job family (Series)
1163 Insurance Examining
- Claims Examiners
- Examiners, Claims
- Examiners, Property And Casualty Insurance Claims
Property And Casualty Insurance Claims Examiners
Conditions of Employment
- Direct Deposit and Social Security Card are required upon appointment
- Meet qualification/eligibility/background requirements for this position
- Satisfactory completion of employment verification (E-Verify) check
- One year probationary period may be required
- If selected, a completed and signed copy of our job application (DA Form 3433) is required prior to entrance on duty.
- Must possess certificate or have the ability to complete the Contracting Officer's Course within three months of employment.
- Must be able to travel overnight as necessary.
- Must possess a valid driver's license.
- Subject to satisfactory completion of all pre-employment checks in accordance with AR 215-3 to include T1 background investigation.
QUALIFICATIONS MUST BE CLEARLY VERIFIABLE IN YOUR RESUME. GOVERNMENT POSITIONS MUST INCLUDE PAY PLAN, SERIES, GRADE, TO AND FROM DATES, AND GOVERNMENT AGENCY/DEPARTMENT. Must include experience at a level which equipped the applicant with the particular knowledge, skills, and abilities needed to perform successfully in the position.
Possess a degree with a major course of study in finance, business administration, economics, insurance, risk management, law, banking and credit, real estate operations or other fields related to this position and experience that would demonstrate knowledge of property and casualty insurance, coverages and claims administration, and the ability to examine a workers' compensation claim. OR Experience applying laws, regulations, and administrative rulings in the performance of such work as determining the kind and amount of insurance necessary to protect government assets; analyzing rates and risk classifications to determine their reasonableness; medical knowledge of occupational hazards to injury, disease and death, and of rehabilitation.
Must possess a certificate of completion for the Contracting Officer's Course OR be able to complete the Contracting Officer's Course within three months of employment.
In addition to the above, highly qualified candidates will possess the following Highly Qualifying Criteria: Experience which demonstrates a comprehensive knowledge of The Longshore and Harbor Workers' Compensation Act and/or Army Regulation 215-1. Experience which demonstrates comprehensive knowledge of Property and Tort Insurance. Possess the Associate in Claims (AIC) Certificate or an equivalent insurance certificate or designation.
Applicants meeting both the minimum qualifications and the highly qualifying criteria may be referred before applicants that only meet the minimum qualifications.
All candidates (to include current employees) are required to include transcripts with their application package if relying on education to meet the minimum qualifications. Failure to do so may result in an ineligible rating. Only education from accredited and pre-accredited institutions will be accepted. Foreign education must be evaluated for equivalency in the United States. For more information, please click here.
- A manual application may be obtained by contacting the servicing NAF Human Resources Office listed on this announcement. If you are applying manually, all required documentation must be received no later than 4:00 p.m., Eastern Standard Time, on the closing date of the announcement. Additional selections may be made from this vacancy announcement for up to 90 days after the closing date.
- Payment of Permanent Change of Station (PCS) costs is authorized based upon a determination that a PCS move is in the Government interest.
- Please check out our application information kit to view additional information you may find useful when applying for our jobs.
- SELECTIVE SERVICE REQUIREMENT: Any individual who was required to register with Selective Service and who is not registered or knowingly and willfully did not register before the requirement terminated or became inapplicable to the individual, will not be appointed.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
Your experience is subject to evaluation and verification against the information in your resume. Do not overstate or understate your level of experience and capability. If a determination is made that you rated yourself higher than is supported by your resume, or if your resume lacks sufficient information, you will be rated accordingly or you may be considered ineligible.
Background checks and security clearance
Drug test required
- Required Documents
The following documents must be submitted with your application:
Optional: Our job application (DA Form 3433) will be accepted in place of a resume. Please note that if you upload multiple resumes, only the most recently uploaded version will be used to determine your qualifications for this position.
The below items are accepted and may be needed to support a qualification and/or claimed priority/preference
- Cover Letter
- Notification of Personnel Action, DA 3434
Including any of the following on your resume may result in an ineligible rating:
Classified or government sensitive information Social Security Number (SSN) Photos of yourself Personal information, such as specifically mentioning your age, gender, race/national origin, etc Encrypted and digitally signed documents Illegible documents or files that cannot be opened
If you are relying on your education to meet qualification requirements:
Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education.
Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.
- How to Apply
How to Apply
Electronicallyhttps://www.usajobs.gov/ and search for announcement number NENAFCC1810321485. All documentation required in the vacancy must be submitted by 11:59 p.m., Eastern Standard Time, on the closing date of the announcement
Agency contact information
CC-NAF-W6BD20 IMCOM FMWR HQ DO NOT MAIL Fort Sam Houston, TX 78234 US
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Referred applicants will be evaluated by a rating panel to determine the quality and extent of total accomplishments, experience, education, and/or certification. The top candidates will be forwarded to the hiring official for selection consideration and may undergo an interview and reference checks.
- Fair & Transparent
Fair & Transparent
The Federal hiring process is setup to be fair and transparent. Please read the following guidance.
Equal Employment Opportunity Policy
The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.
- Equal Employment Opportunity (EEO) for federal employees & job applicants
Reasonable Accommodation Policy
Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application process should follow the instructions in the job opportunity announcement. For any part of the remaining hiring process, applicants should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.
A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.
Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when:
- An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.
- An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.
- An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.
You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.
Learn more about disability employment and reasonable accommodations or how to contact an agency.
Legal and regulatory guidance
- Financial suitability
- Social security number request
- Privacy Act
- Signature and false statements
- Selective Service
- New employee probationary period
This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/512598400. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
Open & closing dates: 10/02/2018 to 10/16/2018
Pay scale & grade: NF 5
Salary: $70,000 to $80,000 per year
Appointment type: Permanent
Work schedule: Full-Time