Case Control Quality Technician

Department of Health and Human Services•Winthrop, MA

18h•Hybrid

About The Position

The Department of Health and Human Services (DHHS) is seeking an experienced and detail-oriented Case Control Quality Technician for Maine Disability Determination Services (DDS). This role involves reviewing and analyzing disability claims data from DDS and the Social Security Administration (SSA) to ensure accurate receipt and closure of claims. The position requires excellent attention to detail, strong organizational skills, and proficiency in proofreading. The Case Control Quality Technician will identify trends in errors and provide instruction to professional staff on proper coding. This role requires the ability to perform technical analysis of medical and vocational data and works under general supervision. This position allows for partial telework after the first 6 months.

Requirements

A two (2) year combination of training and experience at the advanced clerical level in hospital, insurance, or related coding, or in the services of disability determination.
Knowledge of body systems.
Knowledge of vocational systems.
Knowledge of the program operations manual system.
Knowledge of Social Security Administration and department forms.
Familiarity with SSA disability policies and procedures.
Ability to perform technical analysis of medical and vocational data.

Nice To Haves

SSA Disability related experience.

Responsibilities

Reviews disability determination decisions to identify and correct technical coding errors for intake and closure of claims.
Identifies and resolves minor case intake issues, including requesting prior folders or initiating Assistance Requests for local Social Security offices to resolve filing issues.
Accurately prepares and routes paper claims folders to proper destinations.
Mails appropriate notices and pamphlets to claimants and representatives.
Tracks, records, and determines systemic trends in errors to instruct professional staff in correct coding.
Writes and submits reports on coding problems and production trends to comply with state and federal mandates.
Reviews, completes, enters, and retrieves case control documents to maintain accurate computer records.
Analyzes, prepares, and submits case cost reports to provide cost control information.
Assists with outgoing mail processing including use of inserter and postage machines.
May assist with document validation, scanning or other clerical tasks.

Benefits

13 paid holidays
12 days of sick leave
3+ weeks of vacation leave annually
Health Insurance Coverage (State pays 85%-100% of employee-only premiums)
Health Insurance Premium Credit (Participation decreases employee-only premiums by 5%)
Dental Insurance (State pays 100% of employee-only dental premiums)
Retirement Plan (State contributes 14.11% of employee's pay towards MainePERS)
Six weeks of fully paid parental leave for all employees welcoming a child
Additional, unpaid leave may also be available under the Family and Medical Leave Act.

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