Social Insurance Specialist

What You'll Do7

• Review AI-generated social insurance benefit claims, assess the evidence, and check decisions against statutory and regulatory requirements.
• Evaluate eligibility and entitlement decisions for retirement, survivors, disability, and supplemental income programs.
• Complete benefit determinations and calculations, then record the reasoning for AI training.
• Check AI-generated claim decisions against agency policy and program standards such as POMS, and flag errors or inconsistencies.
• Use specialized claims and records systems to access and update claim files and supporting documents.
• Model higher-level decisions for reconsiderations, appeals, and overpayment or underpayment processes.
• Provide written and verbal feedback to improve AI training accuracy and effectiveness.

Requirements3

• The role is remote and limited to applicants in the United States.
• This is a contract engagement.
• No prior AI experience is required.

Preferred Qualifications6

• Experience as a Social Insurance Specialist or in an equivalent role, including eligibility decisions, benefit entitlement, and evidence gathering.
• Familiarity with GS-0105 Social Insurance Administration functions, or related series such as GS-0996 Veterans Claims Examining or GS-0512 Internal Revenue Agent.
• Experience assessing benefit claims and applying program rules in a regulated setting.
• Experience with claims processing or case management platforms, such as SSA’s MCS and MSSICS, or similar systems.
• Quality assurance experience with claims or comparable processes in federal, state, or related agencies.
• Ability to synthesize complex information and present informed decisions for higher-level review.

Who Should Apply

Social insurance specialists with experience in benefit eligibility, entitlement, evidence review, or claims quality assurance may be a strong fit. Familiarity with agency rules and claims systems can help, and previous AI experience is not needed.

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