Disability Claims Specialist

2 weeks ago

Madison, United States Wisconsin Department of Health Services Full time

**Introduction**:
The **Disability Determination Bureau** (DDB) is recruiting to fill multiple Disability Claims Specialist positions.

The DDB consists of approximately 250 employees, including some contractors. The DDB operates on a yearly budget of approximately $30 million funded by the Social Security Administration (SSA) to do medical determinations for SSA disability claims. The DDB also processes a small number of State Medicaid disability claims funded by DHS. The DDB must follow all SSA policies and regulations for safety, security and hiring as well as State of Wisconsin policies and regulations.

As an employee of the State of Wisconsin, you'll also have access to an amazing benefits package, including:

- 3.5 weeks of vacation, 9 paid holidays and ample sick time.
- Top rated health plan options starting at $39/month for single plans and $97/month for family plans, after 2 months of state service.
- Premium pension plan with at least a 6.9% employer match in 2024 for most jobs. Plus a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package
- Several flex spending accounts: medical, dependent care, commuter, and High Deductible Health Savings
- Public Service Loan Forgiveness Program employer.

Our diversity, equity and inclusion team strives to hire, develop and retain a talented workforce representative of the people of Wisconsin. We are searching for people with diverse backgrounds to join our dynamic and team-oriented environment. We promote professional growth and create a healthy work/life balance and inclusive culture.

**Position Summary**:
DDB is hiring for a variety of Disability Claims Specialist (DCS) level positions, which serve as the highest-level examiners within DDB. These positions function under general supervision. Below are short descriptions of possible types of DCS positions we are filling:
As a Quality Analyst (QA), you will:

- Perform formal and technical quality assurance reviews and vocational reviews.
- Provide mentoring, case assistance, and training for trainees and other disability examiners and manage a specialty and non-specialty caseload.
- Review and monitor Federal quality returns and provide guidance and feedback to examiners on corrections.
- Be required to have solid case knowledge of all major case types processed in the DDB, as well as strong policy knowledge and skills interpreting Social Security Disability policy.

As a Cooperative Disability Investigator (CDI), you will:

- Be part of an inter-agency fraud task force, working as an expert on fraud and similar fault issues.
- Create investigative reports, provide training to DDB staff, and conduct policy evaluation of all referrals.
- Manage special workloads, which may include providing case adjudication, quality review, mentoring and case assistance for examiners.
- Be required to have solid case knowledge of all case types in the DDB.
- Attend regular task force meetings with travel to Milwaukee.

**Salary Information**:
The starting salary is between $38.00 to $39.43 per hour (approximately between $79,000 and $82,000 per year), depending on qualification, plus excellent benefits. A 12-month probationary period is required.

**Job Details**:
All applicants who may be appointed to this position will be required to go through a complete federal background investigation. A suitability determination by the Social Security Administration is necessary prior to hire to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems.

For positions that do allow remote working flexibility, although residency in the State of WI is not required for permanent positions, it is not anticipated that working outside of WI or bordering cities will be allowed as positions may at times need to report to office locations in WI on short notice.

Employees must have access to secure high-speed internet for remote work option. Mileage reimbursement to the employee’s headquarter location is not provided.

**Qualifications**:
Minimally qualified applicants will have all of the following:

- Experience adjudicating a combination of the following case types in a State Disability Determination Bureau:

- Initial adult and child claims and Reconsideration adult and child claims
- Continuing Disability Reviews for adult and child claims
- Age 18 Redeterminations
- Experience collaborating in a team setting with co-workers, supervisors and consultants to resolve issues.
- Training and/or experience working with Title II, Title XVI, and Title XIX of the Social Security Act and Amendments

Well-qualified applicants will also have one or more of the following:

- Experience adjudicating prehearing claims at the adult, child and age 18 redetermination levels.
- Experience training and mentoring

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