Claims Examiner- Stone Mountain Job at State of Georgia

State of Georgia Stone Mountain, GA 30083

$65,000 a year

APPLICANTS WITH MEDICAL BILLING, MEDICAL CODING, MEDICAL ASSISTING, CNA OR ACCOUNTING EXPERIENCE ARE ENCOURAGED TO APPLY!

We are excited to announce MULTIPLE openings for this position!

The Georgia Vocational Rehabilitation Agency operates five integrated and interdependent statutory programs that share a primary goal - to help people with disabilities to become fully productive members of society by achieving independence and meaningful employment.

The Georgia Disability Adjudication Services (DAS) is a state agency that makes Social Security disability determinations under an agreement with the Social Security Administration. The DAS is fully federally funded. The main Georgia DAS office is in Stone Mountain with branch offices located in Athens, Dalton, Thomasville and Savannah.

Duties and Responsibilities:

  • Under general supervision provides professional adjudication of Social Security Administration disability claims
  • Develops and adjudicates decisions for initial claims for Social Security and/or Supplemental Security Income disability benefits in accordance with federal and state laws, regulations, policies and procedures
  • Defines the scope of information pertinent to and supporting the application for benefits and develops a strategy to obtain that information
  • Reads and analyzes medical information and evidence received, compares objective medical findings from differing medical sources
  • Applies judgment to ascertain the existence, nature, and severity of the impairment or impairments
  • Evaluates statements, claims and evidence for sufficiency, consistency, validity and credibility
  • Researches medical and vocational issues through the use of written policy and instructional material or consults medical, vocational or other specialists concerning specific issues of the claim
  • Determines eligibility for disability benefits by preparing a formal determination including completion of forms and an explanation of the determination
  • Determines the type of documents necessary to support a decision
  • Using a legal framework establishes pertinent findings of fact and uses those to rationalize and explain disability decisions
  • Incorporates new material and updates knowledge of program standards as a result of reading, feedback and training
  • Review initial claims and applications
  • Request additional information from applicant and review data to see if it fits within the scope of the disability program
  • Analyze data including diagnostic and assessment tests
  • Contact doctors, psychologists, and other health care professionals to obtain information
  • Evaluate occupational information to assess claimants' work potential; explain program eligibility and interpret medical and vocational information
  • Compose technical explanations of decisions
  • Keep current on changes in federal rules and regulations

Minimum Qualifications

Bachelor's degree in a related area from an accredited college or university OR Two years of experience in interpreting and applying laws regarding program eligibility.


Preferred Qualifications

Preference will be given to applicants who, in addition to meeting the minimum qualifications, possess one or more of the items below:

  • Experience with disability, medical, or insurance claims adjudication or investigation, health care, unemployment, workers compensation, social services, or related
  • Prior case management experience (with a social services agency)
  • Experience in claims processing/management
  • Knowledge of medical terminology
  • Computer skills, familiarity with technology,
  • Bilingual/fluent in speaking, reading and writing a foreign language, especially Spanish

What’s in it for you?

  • A workplace that balances productivity with enjoyment, and encourages learning and mentoring.
  • Rewarding work in a fast-paced, creative environment with colleagues who are passionate about public service.
  • A workplace that fosters fairness, equity, and inclusion.
  • Work/life balance, Paid holidays, and a competitive benefits package

Background Check Information:

As a condition of employment with Georgia Vocational Rehabilitation Agency, you must successfully complete a mandatory state, federal and national background check, Pre-employment testing, and additional checks required for your job. In addition, employment with DAS is contingent upon meeting the requirements of Homeland Security Presidential Directive-12.

Your conditional job offer and access to Social Security Administration’s (SSA’s) systems, data, information, and/or premises are contingent upon you passing the SSA suitability process.

  • Note: This covers the preliminary screening (pre-screen) and the final background adjudication stage of the suitability process.

Training Information:

Claims Examiners-Adjudicator 1 Trainees are required to attend an on-site, in-person training for 10-12 weeks as an essential job function. Afterward, in-person attendance in the office is a condition of employment for the first six months. 100% telework is not an option however; the agency may offer a telework schedule as an incentive for employees who meet performance expectations. Selected candidates must meet this requirement with or without an accommodation.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, fax machines and scanners.

Working Conditions:

Incumbents working in this job perform duties in an office setting. This is a 40-hour workweek requirement. The position involves managing a high volume workload and demands a high level of accuracy while working with short deadlines affecting a claimant population in need of monetary and medical assistance. Regular attendance is an important part of being successful in this position. Work is performed in an office environment. Strong computer skills are needed due to ongoing changes to applications that affect the way the work is performed. Reasonable accommodations can be made available to qualified individuals upon request.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

AAP/EEO Statement

GVRA provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

All candidates interested in employment with The Georgia Vocational Rehabilitation Agency must be legally authorized to work in the United States. The Georgia Vocational Rehabilitation Agency does not offer sponsorships for current or future employment visas (e.g., H-B1 employment visa)

Reasonable Accommodations

The Georgia Vocational Rehabilitation Agency is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. To request a reasonable accommodation during any step in the hiring process, please contact our HR Team at ada_request@gvs.ga.gov

Bachelor's degree in a related area from an accredited college or university OR Three years of experience in interpreting and applying laws regarding program eligibility.



Please Note :
caminobluff.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, caminobluff.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.