
Claims professional well-versed in intricacies of claim management and resolution. Known for strategic approach to resolving disputes and ensuring compliance with industry standards. Reliable team collaborator with focus on achieving optimal outcomes and adapting to changing requirements. Skilled in negotiation and critical thinking.
Served as a senior technical authority responsible for adjudicating and resolving complex claims and post-entitlement actions under Title II and Title XVI of the Social Security Act. Applied advanced knowledge of SSA laws, regulations, and the Program Operations Manual System (POMS) to ensure accurate determinations, regulatory compliance, and consistent application of policy.
Provided expert technical guidance and oversight to claims specialists and management, reviewing claims for accuracy, identifying and correcting deficiencies, and resolving non-routine eligibility, entitlement, and payment issues. Functioned as the primary technical resource within the office, exercising independent judgment in cases involving conflicting evidence, sensitive circumstances, and complex beneficiary situations.
Led and delivered formal and informal technical training to all employees in an office of 33 staff members, ensuring proficiency in claims development, policy interpretation, and procedural updates. Served as the subject-matter expert for new hires and experienced employees, providing mentoring, case consultation, and ongoing technical support to maintain workload quality and program integrity.
Worked extensively with the Arizona Department of Child Safety (DCS) and other partner agencies to determine the most appropriate Representative Payee for minor and vulnerable beneficiaries. Coordinated with child welfare professionals to evaluate foster care placements, guardianship, and reunification with parents, ensuring benefit payments aligned with SSA policy and the best interests of the child.
Reviewed court documents, placement records, and custodial information to support representative payee selection, changes, and oversight. Ensured benefits were properly managed for children in foster care or returning to parental custody while maintaining confidentiality and compliance with federal requirements.
Delivered accurate, timely, and equitable service in a high-volume environment, supporting SSA’s mission through strong analytical skills, technical expertise, inter-agency collaboration, and a commitment to quality, accountability, and public trust.