DISABILITY CLAIMS EXAMINER 1* - 03022023-43689 Job at State of Tennessee

State of Tennessee Gallatin, TN

Job Information

State of Tennessee Job Information
Opening Date/Time
Thur 03/02/2023 12:00AM Central Time

Closing Date/Time
Wed 03/15/2023 11:59PM Central Time

Salary (Monthly)
$3,542.00 - $4,425.00

Salary (Annually)
$42,504.00 - $53,100.00

Job Type
Full-Time

City, State Location
Gallatin, TN

Department
Human Services



LOCATION OF (3) POSITIONS TO BE FILLED: DEPARTMENT OF HUMAN SERVICES, REHABILITATION SERVICES - DISABILITY DETERMINATION DIVISION, SUMNER COUNTY

For more information, visit the link below:

Microsoft Word - Disability Claims Examiner 1_Davidson_031523 (tn.gov)

This is a Remote position (Work from Home).

Minimum Qualifications


Education and Experience: Graduation from an accredited college or university with a bachelor's degree.

Substitution of Experience for Education: An Associate’s degree plus two years of full-time professional disability claims examination work may be substituted for the required education.


Other Requirements


Necessary Special Qualifications:

  • Complete a federal background check in accordance with the Homeland Security Presidential Directive 12 (HSPD-12) for issuance of an HSPD-12 compliant Personal Identity Verification (PIV) credential card.
  • After appointment, successfully complete (as indicated by an assessment at completion) a prescribed course of training offered by the Tennessee Department of Human Services.

Job Overview


Summary:

This classification learns to perform disability determination work of average difficulty. An employee in this class is responsible for learning to determine adult medical eligibility for Social Security Disability, Supplemental Security Income or Medicaid benefits for initial claims in accordance with federal Social Security Administration guidelines. This classification performs responsibilities under direct supervision at the learning level. This class differs from the Disability Claims Examiner 2 in that an incumbent of the latter functions at the working level.

  • An applicant appointed to this classification will be reclassified to a Disability Claims Examiner 2 after successful completion of a mandatory one-year training period; ‘unacceptable’ or ‘needs improvement’ performance ratings during the training period will result in automatic demotion or termination.

Work Activities


Responsibilities

  • Learns to determine adult medical eligibility for Social Security Disability, Supplemental Security Income or Medicaid benefits using medical, psychiatric, vocational, and educational data for initial claims in accordance with federal Social Security Administration guidelines.
  • Learns to routinely conduct telephone interviews with claimants and others to clarify information on applications or to obtain additional information as necessary. Learns to determine jurisdiction and proper timeframe for requests of claimant records and obtains records from relevant treatment sources.
  • Learns to independently review and analyze applications, medical assessments, medical records, and vocational assessments as needed for initial claims. Learns to review prior decisions for accuracy and development of evidence.
  • Learns to document case notes, appointments, and general correspondence for review and adjudication. Learns to organize and enter claimant documentary evidence and claim decisions into an electronic case management folder.
  • Learns to assess claimant’s medical conditions to identify impairments, onset issues, and limitations by reviewing medical records, statements, and other pertinent information to prepare a medical assessment.
  • Learns to routinely confer with internal medical consultants and various other subject matter experts to ensure all aspects of disability claims are in accordance with federal guidelines.
  • Learns to schedule consultative examination appointments for claimants and notify claimants, third parties, and attorneys of appointment time and date. Learns to reschedule missed consultative examination appointments and documents reasons for missed exams. Learns to authorize payments for examinations and claimant travel.
  • Learns to review claimant’s work history to determine if claimant’s past work description is adequate and contacts claimant by phone if additional work history is needed. Learns to identify and analyze claimant’s past relevant work by researching jobs and earnings reported to SSA, and compare the claimant’s residual capacity with the functional requirements of the claimant’s past and other work.
  • Learns to select, compose, and send proper federal disability determination notices to claimants explaining medical and vocational decision issues to claimants and authorized representatives.

Competencies (KSA'S)


Competencies:

  • Competent in understanding others and acting with integrity and trust.
  • Competent in determining and setting priorities and meeting timeliness standards
Knowledge:
  • Knowledge of basic computer functions and customer service principles.

Skills:
  • Skilled in active listening and learning, using methods of negotiation, and thinking critically.
  • Skilled in making quality decisions and resolving complex problems.
Abilities:
  • Ability to use deductive and inductive reasoning and be objective and resourceful.
  • Ability to use oral and written communication effectively with sensitivity to problems.

Tools and Equipment Used


Tools and Equipment Used:

  • General office equipment
  • Computer/laptop/tablet
  • Multifunction Printer (Print/scan/fax/copy)
  • Cell phone



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