Disability Claims Examiner jobs in Maine

Disability Claims Examiner reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner typically reports to a supervisor/manager. To be a Disability Claims Examiner typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)

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Disability Claims Adjudicator
  • State of Maine
  • Winthrop, ME FULL_TIME
  • Department of Health and Human Services (DHHS)

    Disability Claims Adjudicator
    Opening Date: April 8, 2024

    Closing Date: April 22, 2024

    Job Class Code: 3065
    Grade:  23 (Pro-Tech)
    Salary: $26.36-$31.03/hour*
    *Employees in this classification begin at $26.36/hour, Step 4 of the pay scale
    Position Numbers: 02024-1607 & 02000-2877
    Location: Winthrop
     

    Are you interested in a career in Public Service and assisting some of Maine’s most vulnerable?  Do you enjoy complex, fast-paced work with a high degree of independence?  Do you want to be part of a growing team and positive work culture? 

     

    Maine Disability Determination Services is hiring!  DDS provides disability decisions for Social Security Disability Benefits.  As a Disability Claims Adjudicator, you request and research prior medical records, collaborate with in-house Doctors and Psychologists around functional limitations, conduct vocational work analyses, and ultimately make disability determinations for the Social Security Administration.  Good candidates will have a dedication to public service, the ability to learn quickly and manage different and complex tasks efficiently and display a collaborative approach with excellent and compassionate customer service.  In-depth training will be provided and a remote option for up to 3 days a week is available after the first 8-12 months.  On-going staff development available as well as the ability to collaborate with many state, local, and federal partners. For more information watch the linked video: https://www.youtube.com/watch?v=j4kzvB78_pI Please note that this video uses the term ‘claims examiner’ which is the same position in Maine as ‘claims Adjudicator’.


    Core Responsibilities:
    This is administrative work involving the review and analysis of initial, reconsideration, and continuing disability review claims for disability benefits under the Social Security Act.  Duties include:
    •    Collect, review, examine, and analyze medical, psychiatric, and vocational claimant reconsideration appeals, continuing benefits applications, and complex initial applications in order to determine final adjudication of eligibility and benefit payments eligibility.
    •    Determine eligibility for disability benefits according to federal regulations, and complete written disability determinations in order to provide assistance.
    •    Determine eligibility for advanced payments for claimants with severe disabilities in order to provide immediate aid to those eligible.
    •    Contact and interview claimants and physicians in order to obtain medical and vocational evidence.
    •    Authorize and arrange for consultations and medical and psychiatric examinations in order to comply with program requirements.
    •    Write detailed letters to claimants, medical consultants, and state and federal agencies in order to request information and inform claimants of the reasons and results of disability decisions.
    •    Assign codes to written decisions in order to develop and maintain statistical data.
    •    Perform additional special duties such as quality assurance, mentoring, training, professional relations activities, processing Canadian claims, and other special projects in order to meet division needs.
     
    Ideal candidates will have:
    •    Ability to work in a production environment with quality and processing speed goals. 
    •    Sensitivity to the needs of the public and customer focus. 
    •    Ability to communicate effectively and work cooperatively through phone, email, video-conferencing, and other communication technologies.  
    •    Attention to detail, analytical and problem-solving skills. 
    •    Ability to learn complex medical information, vocational policies, and ongoing technologies.
    Positive attitude and a desire to work in a team atmosphere. 
     
    Minimum Qualifications:
    A five (5) year combination of education, training, and/or experience providing knowledge and abilities required to obtain, evaluate, and adjudicate information/evidence to form decisions – OR – a bachelor’s degree and 1 year of related experience.
    Your conditional job offer, and access to the Social Security Administration’s (SSA’s) system, 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.

    Thinking about applying?

    Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart.

     

    Agency information: 

    The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers.

    Within the Office for Family Independence (OFI) is the Division of Disability Determination Services (DDS).  DDS is responsible for evaluating and making medical decisions on claims for Social Security disability benefits.  DDS has vacancies in Winthrop. 

     

    Application Information:

    Please submit all documents or files in a PDF format.

    For additional information about this position please contact Mora Camenga at Mora.Camenga@ssa.gov or by phone at (207) 287-9645.

    To apply, please upload a resume, cover letter, and transcript (transcript needed only if education is used to meet the minimum qualifications).

    To request a paper application, please contact Ashley.Smith@Maine.gov .

     

    Benefits of working for the State of Maine:

    No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

    • Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave, and 3 weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
    • Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($10,523.28-$12,380.40 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State. 
    • Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($350.40 annual value).
    • Retirement Plan – The State contributes the equivalent of 13.41% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS). 
    • Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including fathers and adoptive parents—receive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.

     

    State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

     

    Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for part-time employment.

     

    There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role. 

    As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics. 

    If you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.

    Thinking about applying?

    Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart.

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  • Anchorage, AK
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  • World Insurance Associates LLC
  • Syosset, NY
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  • USAble Life
  • Little Rock, AR
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To the south and east is the Atlantic Ocean and to the north and northeast is New Brunswick, a province of Canada. The Canadian province of Quebec is to the northwest. Maine is both the northernmost state in New England and the largest, accounting for almost half of the region's entire land area. Maine is the only state in the continental US to border only one other American state (New Hampshire to the South and West). Maine is the easternmost state in the United States in both its extreme points and its geographic center. The town of Lubec is the easternmost organized settlement in the United...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disability Claims Examiner jobs
$48,644 to $60,397