DISABILITY CLAIMS ADJUDICATOR I (UMP)
About The Position
The Bureau of Disability Determination Services is seeking to hire a Disability Claims Adjudicator to perform responsible, complex administrative, medical and legal work pursuant to the adjudication of initial claims for disability benefits under Title II and Title XVI of the Social Security Act. This position reviews paper or electronic initial claim application, initiates request for necessary medical or non-medical evidence such as job descriptions or activities of daily living through contact by letter or telephone including but not limited to medical treatment sources, employers, Social Security field offices, legal representatives, etc. and prepares and authenticates decision of allowance (establishing onset), denial or a closed period of disability for Illinois residents who have disabling impairments which preclude substantial gainful activity as defined in the Federal regulations.
Requirements
- Requires a bachelor’s degree, with major courses in medical, premedical, legal, prelegal, nursing, psychology, pharmacy, health, biological sciences, physical sciences, business administration, management, or disability claims adjudication.
- OR Requires current valid licensure as a Registered Nurse in the State of Illinois, plus three (3) years of professional registered nursing experience.
- In addition to either of the above, requires successful completion of bureau’s training program OR one (1) year of professional social security disability adjudication experience.
- Requires ability to speak, read, and write Spanish at a colloquial skill level.
- Qualifying state employees, in the employee Upward Mobility Program, may complete combinations of specific proficiency tests and training programs leading to a certificate of proficiency in lieu of the stated requirements for this class.
- Requires ability to pass a federal employment background check. Individuals selected for positions with the Illinois Disability Determination Service (DDS) must go through a complete federal background investigation suitability determination by the Social Security Administration. Those individuals meeting the state requirements for employment must first complete the federal background investigation prior to their start date. This is necessary to determine whether an employee can be issued credentials in order to have access to the Social Security Disability data, records and systems. Further details will be provided during the pre-employment background check process.
Responsibilities
- Examines and analyzes data recorded by Social Security field office obtained through an interview or internet application of clients who file for disability.
- Reviews and assesses medical and lay evidence received through the paper or the electronic case process.
- Obtains full job description of all relevant past employment.
- Reviews regulatory changes, policy guidelines, procedures and transmittals received electronically from state and federal operations, keeps informed of professional and medical technological advances which affect adjudications.
- Develops, updates and maintains skills necessary to generate changes in the interfaced state-federal data control system (coding, diary dates, capability alerts, messages, decisions, etc.).
- Screens all final decisions.
- Communicates in Spanish with claimants regardless of their educational level or type of impairment and effectively handle crisis.
- Provides input to update and maintain current information in the medical reference source book and assess effectiveness of the consultative examination panel physicians.
- Ensures that proper disclosure rules are followed to preserve the confidentiality of the client’s record following HIPPA guidelines.
- Performs other duties as assigned or required which are reasonably within the scope of duties enumerated above.
Benefits
- A Pension Program
- Competitive Group Insurance Benefits including Health, Life, Dental and Vision Insurance
- 3 Paid Personal Business Days annually
- 12 Paid Sick days annually (Sick days carry over from year to year)
- 10-25 days of Paid Vacation time annually - (10 days in year one of employment)
- 13 Paid Holidays annually, 14 on even numbered years
- Flexible Work Schedules (when available dependent upon position)
- 12 Weeks Paid Parental Leave
- Deferred Compensation Program - A supplemental retirement plan
- Optional Pre-Tax Programs such as Medical Care Assistance Plan (MCAP), Dependent Care Assistance Plan (DCAP)
- Federal Public Service Loan Forgiveness Program eligibility
- GI Bill® Training/Apprenticeship Benefits eligibility for qualifying Veterans
- 5% Salary Differential for Bilingual Positions
- Commuter Savings Program (Chicago only)
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
