Unemployment Insurance Claims Adjudicator
Ivan Tavares
Department of Employment Services
Bowie
34
years of professional experience
1
Language
Detail-oriented claims adjudicator with 30+ years of experience in unemployment insurance, appeals, and compliance investigations. Skilled in verifying information, resolving complex disputes, and applying regulations to reach accurate decisions. Strong documentation, decision-making, and verbal communication support consistent results.
Work History
Unemployment Insurance Claims Adjudicator
34 Years 5 Months- Adjudicated unemployment claims using agency regulations and case evidence.
- Reviewed claimant records, employer reports, and supporting documents for eligibility determinations.
- Interpreted employment services policies to resolve complex benefit disputes accurately.
- Processed claims data in agency systems, ensuring complete and timely documentation.
- Communicated determination outcomes to claimants and employers with clear, professional explanations.
- Investigated discrepancies in wage and separation information to support correct adjudication decisions.
- Maintained confidential case files and records in compliance with agency standards.
- Applied quality checks to claim decisions, reducing errors and improving consistency.
- Improved claim processing efficiency by streamlining workflows and implementing time-saving strategies.
Unemployment Insurance Appeals Hearing Examiner
1 Year- Determined benefit entitlement using case facts, documentation, and applicable policy guidelines.
- Interpreted program rules to resolve complex issues in unemployment insurance claims.
- Prepared determinations, notices, and correspondence with clear, consistent findings.
- Reviewed claims files for eligibility, accuracy, and compliance with employment services regulations.
- Adjudicated disputed claims and gathered supporting information for appeals processing.
- Maintained accurate case documentation in claims systems and confidential records.
- Guided staff on policy interpretation, workflow consistency, and procedural accuracy.
- Participated in ongoing professional development opportunities to stay current on industry changes and maintain expertise in the field.
- Contributed positively to organizational reputation by consistently demonstrating professionalism, integrity, and expertise in the role of Examiner.
- Provided clear explanations of decisions made during examinations, enhancing transparency between applicants and organization.
- Managed high volume caseloads, prioritizing tasks to meet strict deadlines while maintaining attention to detail.
- Collaborated with team members to develop best practices for reviewing applications and maintaining accuracy.
- Conducted comprehensive reviews of complex applications, ensuring all necessary documentation was obtained before rendering a decision.
- Served as a subject matter expert on specific industries or types of applications, guiding colleagues in their evaluations when needed.
- Facilitated information sharing among team members to improve overall understanding of complex cases.
- Communicated with customers to resolve common title issues.
- Performed routine data entry or document management.
- Responded to in-person and telephone requests for information from the general public, attorneys and other involved parties.
Investigator
2 Years 3 Months- Led compliance investigations, gathered evidence, and documented findings for corrective action.
- Analyzed case files, records, and reports to identify violations and risk patterns.
- Conducted interviews with witnesses, staff, and stakeholders to verify policy adherence.
- Prepared detailed investigative summaries and recommendations for management review.
- Monitored program activities to ensure alignment with regulations and agency standards.
- Coordinated follow-up actions with internal teams to resolve compliance issues.
- Interpreted policies and procedures to support accurate, defensible investigative decisions.
- Mentored staff on investigative methods, documentation quality, and case management practices.
- Documented findings and prepared detailed reports.
- Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations.
- Improved case resolution rates by conducting thorough investigations and utilizing effective interviewing techniques.
- Maintain a professional tone.
- Ensured compliance with legal regulations during investigations, minimizing risk for litigation or procedural errors.
- Carefully documented statements, observations, and evidentiary materials.
Education
Drafter - Architectural
High School Diploma
Skills
Claims processing
Claims management
Data verification
Government policy regulations
Policy interpretation
Claims documentation
Interviewing techniques
Effective communication
Critical thinking
Decision-making skills
Claimant support
Attention to detail
Attention to detail
Client relationship management
Client rapport
Problem-solving abilities
Accomplishments
- Documented and resolved Unemployment Insurance and Appeal Hearings which led to Determinations based on applicable Federal and local Laws and Policies.
Languages
Spanish
Native or Bilingual
Timeline
Unemployment Insurance Appeals Hearing Examiner
Department of Employment Serices
05.2021 - 05.2022Read More
Investigator
Office of Compliance & Independent Monitoring DC Department of Employment Service
01.2016 - 04.2018Read More
Unemployment Insurance Claims Adjudicator
Department of Employment Services
06.1992 - CurrentRead More
Maryland Drafting Institute
Drafter from Architectural
Read More
Francis L. Cardozo High School
High School Diploma
Read More