Disability Claims Adjudicator

State of Indiana; Indianapolis (IN); On-site; USD 43,000 - 52,000; Full time

Benefits offered by this job

Medical plan options

Health savings account

Pension plan

Paid leave

Education reimbursement

LinkedIn Learning

Free Parking

Job summary

State of Indiana is seeking a Disability Claims Adjudicator to determine Social Security Disability Insurance and Supplemental Security Income eligibility. You will work with physicians, psychologists, and legal guidelines to interpret medical data and issue determinations.

The role emphasizes accurate documentation, clear communication with claimants and attorneys, and collaboration with a multidisciplinary team.

Qualifications

• Extensive knowledge of and the ability to understand and apply the established policies and guidelines of the SSA pertaining to case evaluation, program operation procedures, Privacy Act, FOIA, SSA Rulings, and related decisions.
• Excellent organizational skills and the ability to quickly read voluminous documents in both paper and electronic formats.
• Ability to use multiple computer programs and to handle data accurately and efficiently.
• Ability to present ideas clearly in writing and orally, and to interact tactfully with others.
• Ability to research medical references such as standard medical references and the DSM.

Responsibilities

• Review the disability report and determine the evidence needed to document medical and non-medical facts of record.
• Determine authorization for the purchase of medical records and special consultative examinations.
• Determine eligibility for Presumptive Disability/Blindness payments to effectuate early cash benefit receipt.
• Communicate the rights, responsibilities, and guidelines of the Social Security Disability Program to claimants, attorneys, the medical community, and the public.
• Research SSA program references to determine severity ratings, residual functional capacity assessments, vocational assessments, and other case transactions.
• Analyze medical data in paper and electronic formats, including handwritten notes.
• Confer with clinical psychologists and physicians, assess credibility of symptoms, and draft residual functional capacity assessments.
• Prepare the final determinations of eligibility and write notices of decisions.

Skills

Medical evaluation

Data interpretation

Communication skills

Research skills

Job description

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Begin a fulfilling career with the State of Indiana by joining one of the largest employers in the state, offering a range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package and a commitment to work-life balance. Most importantly, you'll have the chance to make a real and measurable impact on the lives of Hoosiers across Indiana.

About the Family & Social Services Administration (FSSA):

FSSA was established by the Indiana General Assembly in 1991 to consolidate and better integrate the delivery of human services by state government. FSSA is a health care and social services funding agency. Ninety-four percent of the agency’s total budget is paid to thousands of service providers ranging from major medical centers to a physical therapist working with a child or adult with a developmental disability. The seven care divisions in FSSA administer services to more than 1.5 million Hoosiers. FSSA’s mission is to compassionately serve Hoosiers of all ages and connect them with social services, health care and their communities.

Disability Determination Bureau: Title II (Disability Insurance) covers workers who have established eligibility through prior work and Title XVI (Supplemental Security Income) has a needs-based income and resource eligibility requirement. The purpose of these programs is to identify people who have disabilities that preclude the ability to work, or for children, preclude the ability to fully participate in learning activities. These programs have two desired outcomes. The first desired outcome is to correctly identify disabled adults and children. The second desired outcome is to have adults with potential referred to a public or private Vocational Rehabilitation Services, through the Social Security Administration’s “Ticket to Work” program.

Role overview:

The Disability Claims Adjudicator decides on eligibility for Social Security Disability Insurance and Supplemental Security Income Benefits. You will determine medical requirements for these benefits and work closely with staff physicians and psychologists to interpret medical and psychological test results and severity ratings.

The salary for this position traditionally starts at$47,320.00 but may be commensurate with education and work experience. Use our Compensation Calculator to view the total compensation package.

A Day in the Life:

The essential functions of this role are as follows:

• Review the disability report and determine the evidence needed to document medical and non-medical facts of record.
• Determine authorization for the purchase of medical records and special consultative examinations.
• Determine the eligibility for Presumptive Disability/Blindness payments to effectuate early receipt of cash benefits.
• Communicate the rights, responsibilities, and guidelines of the Social Security Disability Program to claimants, attorneys, medical community, and the public.
• Research Social Security Administration program references to determine severity ratings, residual functional capacity assessments, vocational assessments, and other case transactions.
• Analyze medical data in both paper and electronic format, many of which are scanned images of handwritten medical notes.
• Confer with clinical psychologists and physicians, assesses credibility of symptoms, assigns controlling weight of medical opinions and drafts residual functional capacity assessments.
• Prepare the final determinations of eligibility and write grammatically and technically correct notices of decisions.

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

What You'll Need for Success:

Individuals in this role should minimally be able to articulate or demonstrate the following:

• Extensive knowledge of and the ability to understand and apply the established principals, policies and guidelines of the Social Security Administration pertaining to case evaluation, program operation procedures, Privacy Act, Freedom of Information Act, Social Security Rulings, court decisions, vocational rules, and internal business processes.
• Excellent organizational skills and the ability to quickly read voluminous documents in both paper and electronic format.
• Ability to use multiple computer programs, and key data accurately and efficiently.
• Ability to present ideas clearly and effectively, both written and orally, and to deal tactfully with others.
• Ability to research medical references, such as the Merck Manual, Physicians’ Desk Reference, and Diagnostic and Statistical Manual of Mental Disorders.

This person must satisfy the following requirements to continue employment:

• Must successfully pass both the State background check and the Federal HSPD-12 credentialing process.

A degree is not required. However, at least 3+ years of experience applying the outlined knowledge, skills, and abilities in a similar role may be considered.

Individuals should have the ability to perform essential functions with or without reasonable accommodation.

Supervisory Responsibilities/Direct Reports:

This role may be utilized in a supervisory capacity based on agency needs.

Benefits of Employment with the State of Indiana:

The State of Indiana offers a comprehensive benefit package for full-time employees which includes:

• Three (3) medical plan options (including RX coverage) as well as vision and dental plans
• Wellness Rewards Program: Complete wellness activities to earn gift card rewards
• Health savings account, which includes bi-weekly state contribution
• Deferred compensation 457(b)account (similar to401(k) plan) with employer match
• Two (2) fully-funded pension plan options
• A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to:
  • 150 hours of paid New Parent Leave and up to eight weeks of paid Childbirth Recovery Leave for eligible mothers
  • Up to 15 hours of paid community service leave
• Combined 180 hours of paid vacation, personal, and sick leave time off
• 12 paid holidays, 14 on election years
• Education Reimbursement Program
• Group life insurance
• Employee assistance program that allows for covered behavioral health visits
• Qualified employer for the Public Service Loan Forgiveness Program
• Free Parkingfor most positions
• Free LinkedIn Learningaccess

The State of Indiana is an Equal Opportunity Employer and is committed to recruiting, selecting, developing, and promoting employees based on individual ability and job performance. Reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process as well as perform the essential functions of a role. If you require reasonable accommodations to complete this application, you can request assistance by contacting the Indiana State Personnel Department at [e-mail] .