Disability Claims Specialist
State of Illinois•Springfield, MO
•Hybrid
About The Position
The Division of Rehabilitation Services is seeking a detail-oriented Disability Claims Specialist to provide technical advice and serve as a resource on claim-related matters to adjudicators and adjudicator trainees. The position adjudicates assigned disability-claims backlog in compliance with state and federal guidelines, ensuring accuracy and expediency. It also analyzes complex claims involving medical and vocational issues, maintaining the integrity of documentation and accurately evaluating medical, functional, and vocational evidence.
Requirements
- Bachelor's degree with major coursework in medical, premedical, legal, prelegal, nursing, psychology, pharmacy, health, biological sciences, physical sciences, business administration, management, or disability claims adjudication; OR current valid Illinois Registered Nurse licensure plus three years of professional registered nursing experience.
- Two years of progressively responsible professional experience as a Disability Claims Adjudicator II.
- Ability to pass a federal employment background check and complete the Social Security Administration's federal background investigation and suitability determination before starting.
Responsibilities
- Audit aged cases and analyze trends that lead to delays.
- Adjudicate assigned backlog of disability claims in compliance with state and federal guidelines to ensure accuracy and expediency.
- Analyze complex disability claims involving medical and vocational issues to ensure compliance with state and federal guidelines, documentation integrity, and accurate evaluation of medical, functional, and vocational evidence.
- Assist with Cooperative Corrective Action Plans for the Division of Adjudication Services.
- Promote and maintain professional relationships with key providers.
- Review requests for additional testing and approve or deny them.
- Perform other duties as assigned or required that are reasonably within the scope of the listed duties.
Benefits
- Pension program
- Group health insurance
- Life insurance
- Dental insurance
- Vision insurance
- 3 paid personal business days annually
- 12 paid sick days annually, with carryover
- 10–25 days of paid vacation annually (10 days in the first year)
- 13 paid holidays annually, and 14 in even-numbered years
- Flexible work schedules when available and dependent on position
- 12 weeks of paid parental leave
- Deferred compensation supplemental retirement plan
- Optional pre-tax Medical Care Assistance Plan and Dependent Care Assistance Plan
- 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)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
