Job Description Summary
Under the Cost Reimbursement program, the Social Security Administration pays State Vocational Rehabilitation (VR) agencies compensation in the form of reimbursement when beneficiaries served by State VR agencies enter the workforce and achieve nine continuous months of earnings. State VR agencies can serve as Employment Networks (EN) in the Ticket to Work (Ticket) program or under Social Security's State VR Reimbursement Program. State VR agencies are the only programs authorized by law and automatically approved to provide service to beneficiaries under the Ticket program without becoming an EN.
Maximus’ Vocational Reimbursement (VR) Payments department work with SSA to initiate and implement quality control and quality assurance activities into processes resulting in an effective method for ensuring that VRs are properly compensated. VR Senior Payment Specialists’ (SPS) ongoing efforts to validate and improve the accuracy and timeliness of payment processing help minimize unnecessary draws on SSA funds and maintain strong relationships with VRs. VR Payments SPS staff process 100% of all payments to VRs. The staff also creates Payment Denials to notify VRs of claims the staff are unable to pay. The staff creates and process these Payment denials for claims VRs submit and claims that payment staffs determine as 'not available'.
Essential Job Duties:
Administer the VR payment process and maintain the requisite documentation needed to make payments to EN’s.
Review VR payment requests for accuracy and completeness and process payment when appropriate.
Apply VR policy and rules when analyzing claims to make payment determinations.
Analyze documentation VRs submit to support payment requests for reimbursement of monies VRs paid to disabled beneficiaries for support services.
Function as SSA’s intermediary in the resolution of payment issues with the VR’s. The VR SPS shall work to resolve inconsistent documentation and other issues of conflict and to clarify proper payment amounts. SSA will serve as the final arbiter in cases involving payment disputes and overpayments.
Report and document the issue of overpayment
Monitor work queues to ensure all claims are reviewed in a timely manner and process cases using the First In First Out (FIFO) inventory method.
Analyze primary wage evidence, SSA quarterly earnings reports (VCER), create wage reports and enter detailed information into Social Security's electronic wage reporting worksheets (eWork) when appropriate to allow Social Security field offices to perform work Continuing Disability Reviews (CDR)
Upload digital images of primary earnings evidence (e.g., pay stubs) into SSA's NDRED system.
Verify earnings data. The staff shall apply Social Security Administration rules and policies to identify various types of earnings determine if beneficiaries achieved earnings at substantial gainful activity (SGA) for a nine-month period.
Create work cases electronically and process claims in SSA’s Internet Ticket Operations Support System (iTOPSS) when VRs submit claims manually
Maintain electronic file of payment requests, awards, and denials
Education and Experience Requirements:
High School Diploma or GED required; three or more years previous experience in finance/accounting, claims processing or bookkeeping - Strong analytical skills - Strong database and PC applications experience (MS Word, Excel, Visio) - Previous experience in managing cases (MAXIMUS or SSA systems and subsystems) - Strong problem solving skills - Strong attention to detail - Mathematical and spreadsheet/accounting skills Organizational, interpersonal, written and verbal communication skills - Must be detail-oriented and demonstrate the ability to perform comfortably in a fast-paced, deadline-oriented work environment - Ability to execute many complex tasks simultaneously - Ability to work as a team member - Previous experience auditing claims or financial reports preferred
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Follow procedures and directions to assess the quality of service provided through monitoring incoming calls and other work types which focusing on the quality of customer service, accuracy of information provided, and adherence to established polices and procedures.
- Conduct call monitoring sessions to ensure workers are performing in accordance with established quality and performance standards.
- Provide feedback on call monitoring results.
- Evaluate recorded and/or transcribed interactions of a complex nature between the caller/chatter/correspondent and the worker, and provide appropriate context of ratings.
- High School Diploma with Associate degree and/or 2-4 years of experience.
- May have training or education in area of specialization.
Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit [ Link removed ] - Click here to apply to Sr. Payments Specialist
EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
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