Att B Labor Categories_Claims Admin.doc

Attachment B

Labor Categories

The following labor categories are described by requirement and qualification, Additional labor categories may be proposed and considered to complete the requirements contained in the Government’s Statement of Work. This information, combined with the Draft Statement of Work, provides the total requirements and category specific requirements.

Project Manager

The Project Manager shall be a permanent and cleared position and shall perform the following activities:

· Manage execution of the contract and task order for the project and coordinate with the COTR for all contract related matters

· Serve as the initial point of contact for administrative and technical matters pertaining to performance requirements

· Track workload, work performance, and progress, and report to the COTR as required

· Supervise staff

· Execute the Contractor's quality control program

· Recruit and hire all supervisors/ managers with approval and maintain final approval on all other recruiting and hiring

· Ensure sufficient numbers of cleared staff are on-board and ready to commence claims administration activities when a task order is received

· Execute the Contractor's training program within assigned area of responsibility

· Be routinely available during normal hours of operation (an alternate may be appointed during any period of absence)

A Project Manager must possess a Master’s degree, or equivalent experience as a Project Manager, with at least five years of experience as a Project Manager of similar projects is required. Attention to detail and the ability to read and follow directions are very important. Good oral and written communications skills are highly desirable. A Project Manager must have one year of experience in a field related to claims administration and at least one year experience as a supervisor. He/she must possess a demonstrated ability to analyze documents to extract information.

Senior Claims Analyst

Provide analysis and review of claims files including:

· Reviewing claims data and assessing legitimacy of claimant information and eligibility for disbursements

· Formulating administrative and technical procedures for accomplishing the work

· Extracting data from databases

· Obtaining additional information from other investigative agencies/databases

· Maintaining physical files and documentation of analyses and results

· Reviewing internal information on the status of claims and dispositions

· Assuring information is accurate and performing analytical computations necessary to process data

· Receiving and distributing documents

· Assisting other Analysts and Records Examiners and officials in obtaining/collecting all documents/information to complete a claim file analysis

· Providing administrative information and assistance concerning claims to other investigative agencies, local law enforcement agencies, U. S. Attorney, other DOJ processing units, headquarters, and offices

· Extracting data from databases for management and program reports

· Reviewing and analyzing financial data, documents, and manual or automated accounting systems

· Contacting and/or responding to potential and actual claimants to review claims, gather additional information, and provide necessary follow-up

· Verifying potential claimants do not have outstanding liens or debts that would make them ineligible for distributions

· Preparing proposed and final distribution lists

· Performing word processing and data entry relevant to claim documentation

· Coordinating with the Project Manager to provide relevant and up-to-date case information and analyses for reporting purposes

A Senior Claims Analyst must have the ability to:

· Review and analyze data and information from multiple sources

· Enter and retrieve data from databases

· Prepare and format management reports

· Manipulate, transfer, compute, and print information

· Create and manipulate spreadsheets

· Prepare and correct reports and correspondence using word processing software.

· A Senior Claims Analyst must have a four-year undergraduate degree in a relevant field. A Senior Claims Analyst must have one year of experience in claims administration and at least one year experience as a supervisor. He/she must possess a demonstrated ability overseeing the processes and staff in analyzing documents and reviewing claims data in order to assess the legitimacy of claimant information and eligibility for disbursements.

Claims Records Examiner

Provide organization and management of claims files and claims analysis including:

· Reviewing data (completeness of information, proper execution) from multiple sources and reconciling inconsistencies

· Extracting data from databases

· Obtaining additional information from other investigative agencies/databases

· Establishing/maintaining physical files

· Receiving files, data, petitions, claims, and process requests

· Preparing declarations

· Conducting initial validation and verification of claim files and data systems

· Maintaining internal status information on the status of claims and dispositions

· Assuring information is accurate and performing analytical computations necessary to process data

· Receiving and distributing documents

· Assisting other Records Examiners and officials in obtaining/collecting all documents/information to complete a claim file and providing up-to-date case information to Senior Claims Analysts

· Extracting data from databases for management and program reports

· Performing word processing and data entry relevant to claim documentation

· Manipulating, transferring, computing, and printing information

· Creating and manipulating spreadsheets

· Preparing and correcting reports and correspondence using word processing software

· Troubleshooting and performing quality control spot checks

A Claims Records Examiner must have a four-year undergraduate degree in a relevant field or relevant applicable experience equal to a four-year degree. Attention to detail and the ability to read and follow directions are very important. Good oral and written communications skills are highly desirable. Must have one year of experience in claims processing, and must possess a demonstrated ability to analyze documents to extract information.

Systems Programming Analyst

Provide system and web support including:

· Providing programming services in support of claims receipt and processing

· Testing and correcting programming

· Resolving data processing problems

· Preparing instructions for operators and users

· Modifying programming to increase operating efficiencies or respond to changes in work processes

· Maintaining records and documenting program development and revisions

· Investigating the feasibility of solving problems through new or modified computer programs and conducting necessary fact-finding activities concerning specified work processes

· Participating in the overall program planning with other users and personnel

· Developing, modifying, and maintaining assigned programs

· Designing and implementing modifications to the interrelation of files and records within programs

· Defining objectives, priorities, and deadlines

· Ensuring web operations are functioning and potential and actual claimants are able to access necessary forms and information

· Developing complete specifications

· Preparing work diagrams and data flow charts

· Developing new subsystems such as cost analysis records in which each type is automatically processed through the full system of records

A Systems Programming Analyst requires competence in all phases of systems analysis techniques, concepts, and methods and knowledge of available system software, computer equipment, and the regulations, structure, techniques, and management practices of one or more subject-matter areas.

Paralegal

Provide legal review of claims and general legal advice including:

· Reviewing case materials and documents to become familiar with questions under consideration and extract selected data and information

· Noting and correcting claim file deficiencies (e.g., missing documents, inconsistent material, leads not investigated) and coordinating with Analysts and Examiners prior to submission of final claim distribution report

· Consulting prescribed sources of information for facts related to claims

· Verifying citations and legal references on prepared legal documents

· Gathering, sorting, classifying, and interpreting claims data to discover patterns of possible illegal activity

· Preparing summaries of testimony and depositions

· Drafting and editing non-legal memoranda, research reports, and correspondence relating to claims

· Noting possible deficiencies in claim materials (e.g., missing documents, conflicting statements) and additional issues or questionable matters

· Searching for and summarizes relevant articles in trade magazines, law reviews, published studies, financial reports, and similar materials for use of attorneys in the preparation of opinions, briefs, and other legal documents.

· Interviewing potential claimants and prepares summary interview reports for review

A Paralegal must meet the following qualifications:

· Possess a paralegal certificate

· At least one year of litigation paralegal experience

· Automated litigation support experience very helpful

· Basic legal knowledge, including knowledge of standard legal citation system sufficient to perform basic legal research

· Excellent written and oral communication skills, thorough knowledge of legal research tools

· Hands-on familiarity with a variety of computer applications, including word processing, database, spreadsheet, and telecommunications

· Ability to consistently deliver highest quality work under extreme pressure

Clerical Support

Provide general clerical support including:

· Coding, filing, and maintaining a variety of documents and records

· Opening mail and processing mail, including sorting pieces and calculating postage for outgoing mail

· Operating basic office equipment (e.g., photocopier, facsimile, multi-line phone/voicemail systems, mailing machines, shredder, and minimal computer programs)

· Answering and responding to claim inquiries and/or directing calls to appropriate personnel (including emails)

· Providing live operator services for potential claimants as required

· Typing forms, correspondence, and providing general word processing services

· Performing on-line data updates and verification, creation of new records, off-line modification of records, and entering of data

· Answering inquiries regarding case-related information and status

· Scheduling appointments and meetings and providing support as necessary

· Updating responses to frequently asked questions

This position must be fully capable of reading, writing, understanding, and speaking English. Attention to detail and the ability to read and follow directions are very important, and good oral communications skills are highly desirable.

Procurement Sensitive Page B-1

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