SRA International, Inc., A CSRA Company OPM Case Reviewer: Level 1 in United States
Clearance Level Must Currently Possess:
No Active Clearance Required
Clearance Level Must Be Able to Obtain:
Top Secret SSBI (Single Scope Background Investigation)
CSRA , an emerging leader in the background investigations industry,will support a large national background investigations (BI) program that provides investigative products and services to departments and agencies of the federal government. BIs are required to determine an individual’s suitability for employment with the federal government, eligibility for access to classified information, assignment to or retention in positions with sensitive duties, or other designated duties requiring such investigations. The investigations often involve personal and intimate details of an individual’s life and must be processed and conducted with tact and discretion. Information collected by the investigator as part of the BI is protected under the Privacy Act of 1974. The Office of Personnel Management, Federal Investigative Services (OPM-FIS) provides investigative products and services for over 100 Federal agencies to use as the basis for suitability and security clearance determinations as required by Executive Orders and other rules and regulations. OPM provides over 90% of the Government's background investigations, conducting over two million investigations a year. CSRA provides field investigative support to OPM's Field Investigative Support program in safeguarding the nation by conducting nationwide background investigations on behalf of OPM. The Case Reviewer level 1 position is an entry level position that provides all aspects of processing and completing critical investigative reports for OPM. Essential Job Functions Analyzes insurance and other types of claims including matured endowment claims to ensure compliance with organizational and government guidelines. Maintains an ongoing effort to determine and maintain equity with current claims trends. Conducts analysis of current claims trends and investigates means to improve claim processes. Researches and investigates claims systems to evaluate potential impact to organization. Analyzes claims financial reporting practices and reconciliation for client companies. Informs management of potential liabilities or process improvements related to current claims practices. May review various types of claims such as property and casualty claims to ensure adherence to policies and guidelines. Approves processing of appropriate payment in accordance with guidelines. Rejects or partially rejects claims or documentation in accordance with appropriate policies and guidelines. Negotiates with appropriate stakeholders including claimant, attorneys, vendors, etc. to ensure accurate processing. Provides explanations or information regarding the policies, guidelines or documentation in order to ensure understanding. May provide training to other appropriate stakeholders in relation to policies. Provides analysis, support and documentation as necessary in relation to the claims appeal process. Obtains expert opinions or documentation in relation to claims; analyzes to ensure appropriate application of claims. Provides analysis, support and assistance to vendors or contractors when conducting the reinspection process. Assists in evaluating, analyzing, and assembling final investigative reports in prescribed customer format. Provides in-depth investigative oversight to field investigators performs extensive analysis of investigative tasks, develops detailed knowledge of client’s objectives. Brings conclusion to investigations in a rapid, suspense-oriented work environment. Analyzes public records, such as law enforcement reports, bankruptcies, judgments, and collection actions against the subjects of investigations. Scoping (determining areas and scope of investigative coverage in accordance with applicable directives, and investigative standards) Generating leads to task field investigators to meet investigative requirements Case analysis (analyzing work submitted from field with OPM investigative requirements) Reviewing complete Repo rts of Investigations and possible lead work Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities. Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates. Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design. Assists in developing and modifying systems requirements documentation to meet client needs. Participates in meetings with clients to gather and document requirements and explore potential solutions. Executes systems test from existing test plans. Assists in analyzing testing results in all phases. Participates in technical reviews and inspections to verify 'intent of change' is carried through phases of project. Basic Qualifications Bachelor's degree or equivalent combination of education and experience Bachelor's degree in insurance, business administration or related field preferred Zero or more years of claims processing experience Experience working with insurance software such as Lotus Notes, Vantage, DRPS, Life 70, Keymaster and CK4 Experience with investigating internal claims practices Experience working with appropriate claims processing procedures and documentation, and experience with administrative procedures, legislative requirements, and medical principles as they relate to examination and approval of various types of claims such as property and casualty, life and disability insurance claims Other Qualifications Good analytical and problem solving skills Good interpersonal skills to interact with team members Good communication skills to communicate with clients Ability to keep sensitive and confidential material private Ability to work in a team environment
# of Openings:
Scheduled Weekly Hours:
T elecommuting Options:
USA PA Blair County, Martinsburg - Home Office (PAHOME)
Additional Work Locations:
CSRA is committed to creating a diverse environment and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
THINK NEXT. NOW.
CSRA is tomorrow’s thinking, today. To “Think Next. Now.” is to imagine a better future and to deliver it, today. For our customers, our partners, and ultimately, all the people our mission touches, CSRA is realizing the promise of technology to change the world through next-generation thinking and meaningful results.
We understand that our customers' missions require new methods and imaginative thinking. We bring together government IT professionals, emerging technologies, and the brightest, cutting-edge advisors in the industry to deliver a broad range of innovative, next-generation IT solutions and professional services to help our customers modernize their legacy systems, protect their networks and assets, and improve the effectiveness and efficiency of mission-critical functions for our warfighters and our citizens.
Everywhere you look, CSRA is there. We’re in our nation’s infrastructure, in training and education, in cyber security, in serving veterans who served us—and, so much more. Take some time to learn more about CSRA. You might be surprised to learn how we touch your life.
We are a company of 18,000+ smart, talented individuals, yet we enjoy a start-up culture that inspires us to make a difference while delivering results in this rapidly evolving world. Join our team and use your skills and expertise to support the safety, security, health and well-being of the nation.