Claims Clerk

MaineGuide; Winthrop, Northern (ME, KY); Hybrid; USD 65,761,000 - 88,971,000; Full time

Job summary

Staffing Solutions Organization LLC (SSO) is recruiting for Claims Clerk positions in Winthrop, Maine. The role supports disability claim adjudication with document gathering, medical evidence organization, and correspondence management. Training will determine hybrid eligibility after onboarding.

These are full-time roles with on-site start and potential for hybrid work after successful training. Candidates should have strong customer service, administrative skills, and proficient use of

Qualifications

• Strong customer service and communication skills.
• Basic knowledge of office procedures and administrative practices.
• Ability to follow written and verbal instructions.
• Proficiency with Microsoft Office applications and data entry.
• Ability to review documents for accuracy and completeness.
• Strong organizational and recordkeeping skills.

Responsibilities

• Contact claimants and providers to obtain medical and vocational documentation.
• Follow up on outstanding requests for timely records.
• Organize and prepare medical records for adjudicative review.
• Coordinate examinations and schedules for claimants.
• Summarize documentation to support disability claim evaluations.
• Document claim-related activities and correspondence.

Skills

Customer service

Communication

Organization

Microsoft Office

Data entry

Tools

Electronic document management systems

Job description

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Claims Clerk - 7 Openings

Location: Winthrop, Maine

Pay Rate: $27.00 per hour

Schedule: Full-Time, 40 Hours per Week

Work Arrangement: Onsite to Start | Hybrid Eligible Upon Successful Training

Position Overview

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.

Key Responsibilities

Claims Support & Evidence Collection

• 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.

Case Coordination

• 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.

Customer Service & Communication

• 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.

Records Management

• 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.

Minimum Qualifications

Candidates should demonstrate:

• 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

Preferred Qualifications

The following experience is highly desirable but not required:

• 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

Knowledge, Skills & Abilities

Successful candidates will have:

• 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

Schedule & Work Environment

• Full-time, 40 hours per week
• Scheduled between 7:00 AM and 5:00 PM
• No on-call responsibilities
• Hybrid work opportunity available after successful completion of training and demonstrated independent performance

Background Check Requirement

The selected candidate must successfully complete a Tier II Social Security Administration background investigation prior to employment.

Requirements include:

• Fingerprinting
• Identity verification
• A valid government-issued photo ID that is REAL ID compliant

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.