DHS SENIOR DISABILITY CLAIMS EXAMINER - 08192025-70512

Job Information

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF HUMAN SERVICES, REHABILITATION SERVICES - DISABILITY DETERMINATION DIVISION, DAVIDSON COUNTY

For more information, visit the link below:
https://www.tn.gov/content/dam/tn/human-services/documents/HRC0015106_DHS_SR_DISABILITY_CLAIMS_EXMR_Davidson_82525.pdf

This position is designated as Work from Home (Remote)

This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Qualifications

Education and Experience: Bachelor's degree and experience equivalent to three years of full-time professional SSA disability claims examination work.

Substitution of Experience for Education: Additional full-time professional SSA disability claims examination work may be substituted for the required bachelor's degree on a year-for-year basis.

Necessary Special Qualifications: Applicants for this class must complete a federal background check in accordance with the Homeland Security Presidential Directive 12 (HSPD-12) for issuance of an HSPD-12 compliant Personal Identity Verification (PIV) credential card.

Overview

This class performs disability determination work at the lead level. An employee in this class is responsible for the adjudication of continuing disability cases, special court ordered or administratively ordered reviews, and pre-hearing claimant eligibility for disability benefits. This class differs from that of the Disability Claims Examiner 2 in that an incumbent of the latter performs duties with a lesser degree of autonomy and increased responsibility for initial disability determinations.

Responsibilities

1. Determines and redetermines adult and child medical eligibility for Social Security Disability, Supplemental Security Income, or Medicaid benefits using medical, psychiatric, vocational, and educational data for initial, reconsideration, continuing disability, and pre-hearing claims in accordance with Social Security Administration (SSA) guidelines. May mentor claims examiners and assist with best practices.
2. Routinely conducts telephone interviews with claimants and others to clarify information on disability redetermination applications and/or to obtain additional information to expedite the continuing disability claims process. Educates claimants and authorized representatives to ensure clear understanding of the continuing disability process.
3. Verifies proper time frame for requests of claimant records and obtains records from relevant treatment sources. Selects, composes, and sends proper disability determination notices to claimants and authorized representatives explaining medical and vocational decisions.
4. Independently reviews and analyzes applications, current and prior impairments, newly discovered allegations, medical assessments, medical records, and vocational assessments as needed for initial, reconsideration, continuing, and pre-hearing disability claims.
5. Organizes and enters claimant documentary evidence and claim decisions into a paper or electronic case file. Documents case notes, appointments, and general correspondence in case notes for review and adjudication.
6. Assesses claimant's medical conditions to identify impairments, onset issues, and limitations by reviewing medical records, statements, and other pertinent information to prepare and compose a medical assessment. Routinely confers with internal medical consultants and various other subject matter experts to ensure all aspects of disability claims are in accordance with SSA guidelines.
7. Schedules/reschedules consultative examination appointments for claimants and notifies claimants, third parties, and attorneys of appointment time and date, and documents reasons for any missed exams. Authorizes payments for examinations and claimant travel.
8. Reviews claimant's work history to determine if claimant's past work description is adequate and contacts claimant by phone if additional work history is needed. Identifies and analyzes claimant's past relevant work by researching jobs and earnings reported to SSA, and compares the claimant's residual capacity with the functional requirements of the claimant's past and other work.

Competencies (KSA's)

Competencies:

1. Customer Focus
2. Resourcefulness
3. Communicates Effectively
4. Instills Trust
5. Situational Adaptability

Knowledges:

1. Customer and Personal Service

Skills:

1. Active Learning and Listening
2. Critical Thinking
3. Complex Problem Solving
4. Judgment and Decision Making
5. Time Management

Abilities:

1. Deductive Reasoning
2. Inductive Reasoning
3. Written Comprehension
4. Problem Sensitivity

Tools & Equipment

1. General Office Equipment
2. Computer/Laptop/Tablet
3. Cell Phone