Claims Clerk

Staffing Solutions Organization LLC (SSO)•Winthrop, ME

11d•Hybrid

About The Position

The Maine Disability Determination Services (DDS) is seeking a detail-oriented and customer-focused Claims Clerk to support the disability claims adjudication process. In this role, you will assist the adjudicative team by gathering information, obtaining and organizing medical evidence, coordinating communications, and maintaining accurate case documentation. While this position does not make disability determinations, it plays a critical role in ensuring claims are thoroughly documented and efficiently processed. This is an excellent opportunity for candidates with administrative, claims processing, customer service, medical office, or social services experience who enjoy working in a fast-paced environment where attention to detail is essential.

Requirements

Strong customer service and communication skills
Basic knowledge of office procedures and administrative practices
Ability to follow written and verbal instructions
Ability to manage multiple tasks while maintaining accuracy and attention to detail
Proficiency with Microsoft Office applications and other computer-based systems
Ability to perform routine data entry and keyboarding tasks
Ability to review documents for accuracy and completeness
Strong organizational and recordkeeping skills
Ability to work independently and as part of a team
Exceptional attention to detail
Strong written and verbal communication skills
Ability to handle sensitive and confidential information
Professional telephone etiquette
Strong organizational and time-management skills
Ability to prioritize work and meet deadlines
Experience maintaining electronic and paper filing systems
Ability to learn and apply agency policies and procedures
Fingerprinting
Identity verification
A valid government-issued photo ID that is REAL ID compliant
Applicants must be authorized to work in the U.S.

Nice To Haves

Medical records administration
Medical terminology
Disability claims processing
Social Security or public benefits programs
Healthcare administration
Insurance, workers' compensation, or claims-related support work
Electronic document management systems

Responsibilities

Contact claimants, healthcare providers, employers, and authorized third parties by phone and mail to obtain medical and vocational documentation.
Follow up on outstanding requests to ensure timely receipt of records and supporting evidence.
Collect, organize, review, and prepare medical and psychiatric records for adjudicative review.
Assist in summarizing and organizing documentation to support disability claim evaluations.
Schedule and coordinate medical and psychological consultative examinations as directed by adjudicators and medical consultants.
Communicate examination details and appointment reminders to claimants.
Track and document claim-related activities and correspondence.
Respond to incoming calls regarding claim status and general inquiries.
Return voicemails and provide timely, professional assistance to claimants and providers.
Conduct required survey and follow-up calls.
Review paper claim files and convert records to electronic format.
Scan, index, and maintain electronic documentation.
Ensure files are complete, accurate, and organized in accordance with agency requirements.