Claims Examiner 2 - Stone Mountain

Full Time
Stone Mountain, GA 30083
$25 an hour
Posted
Job description

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.

Position Overview:

Disability Adjudication Services (DAS) makes Social Security disability determinations under an agreement with the Social Security Administration. Provides professional disability adjudication for Social Security Administration disability applicants. Independently makes eligibility determinations on all types of disability claims involving all categories of disabilities; and performs other duties as required. The main DAS office is in Stone Mountain with branch offices located in Athens, Dalton, Thomasville, and Savannah.

The position filled through this announcement will be a member of the Claims Processing team and will be based in Stone Mountain, Georgia.

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 information. Reads and analyzes medical information and evidence received, compares objective medical findings from differing medial 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, reconsideration, and continuing disability review claims and applications
  • Request additional information from applicant and review data to see if it fits within the scope if 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

Successful Competencies:

  • Accountability-Being accountable and passing on accountability for one's own actions. Adheres to deadlines and appointments; Transparent when he/she anticipates problems or errors; Delivers work on time and as agreed; Takes responsibility for mistakes.
  • Critical Thinking-Ability to identify an issue, dilemma, or problem; Frame it as a specific question; Explore and evaluate information relevant to the question; and Integrate the information into development of a resolution. Uses knowledge, comprehension, application, analysis, syntheses, and evaluation as steps in this process.
  • Judgment and Decision Making-Ability to make active decisions. Makes decisions authoritatively and wisely, after adequately contemplating various available courses of action; Considers alternative available actions, resources, and constraints before selecting a method for accomplishing a task or project; Refrains from "jumping to conclusions" based on no, or minimal evidence; Takes time to collect facts before decision-making; Considers the long-term as well as immediate short-term outcomes and actions; Recognizes when to escalate appropriate or specific situations to the next higher level of expertise.
  • Focus on Quality-Setting high quality standards and striving for continuous improvement and quality assurance.
  • Initiative-Ability to recognize and create opportunities and to act accordingly. Adopts a proactive attitude as opposed to waiting to be asked; Creates and uses opportunities.
  • Problem Solving/Analysis-Ability to detect problems, recognize important information, and link various data; Trace potential causes and look for relevant details; Distinguishes essentials from side-issues; Works and thinks at a level appropriate to his/her position; Sees connections between difference problems; Not satisfied with incomplete information; Wants to find out more.

Minimum Qualifications:

Bachelor degree in a related area from an accredited college or university AND Two years of experience interpreting and applying laws regarding program eligibility OR Two years of experience required at the lower level Adjudicator 1 (LEPO l 0) or position equivalent.

Preferred Qualifications:

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

  • Twenty-four months or more of consecutive experience adjudicating Initial Adult and Disability Childhood Claims (DC), Reconsideration Claims, and/or Continuing Disability Review Claims within the last two years. Adjudication experience must have been attained as an Examiner or Adjudicator in a state or federal Disability Determination Services Agency, interpreting and applying laws regarding medical program eligibility.
  • eCAT experience within the last two (2) years
  • 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 (applicants will be fingerprinted), pre-employment testing, and additional checks as required for this role. 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.

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 may involve managing a high volume workload and demands a high level of accuracy while working with deadlines. Regular attendance is an important part of being successful in this position. 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 AND Two years of experience interpreting and applying laws regarding program eligibility OR Four years of experience interpreting and applying laws regarding program eligibility OR Two years of experience required at the lower level Adjudicator 1 (LEP010) or position equivalent.

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