CLAIMS ADJUSTER, EXAMINER & INVESTIGATOR

Req No: 64083506-51199365-20080717083819
Agency Name: DOH - Health
Description:
OCCUPATION PROFILE
Working Title:
MEDICAL DISABILITY EXAMINER
Broadband/Class Level:
CLAIMS ADJUSTER, EXAMINER & INVESTIGATOR - Level 3
Broadband/Class Code:
13-1031-03
Pay Grade/Pay Band:
BB007
Position Number:
64083506
Closing Date:
7/28/2008
Location:
JACKSONVILLE
County:
Duval County
Annual Salary Range:
$32,537.96-$51,489.88
Announcement Type:
Open Competitive
Facility:

DESCRIPTION:
OCCUPATION PROFILE
JOB FAMILY: BUSINESS AND FINANCE
OCCUPATIONAL GROUP: BUSINESS OPERATIONS
OCCUPATION: CLAIMS ADJUSTERS, EXAMINERS AND INVESTIGATORS
13-1031
**FINGERPRINTING AND BACKGROUND CHECK REQUIRED***AN EEO/EE EMPLOYER***MULTIPLE POSITIONS WILL BE FILLED FROM THIS AD******One year of professional experience in counseling, teaching, a benefits program involving adjusting, examining, investigating, or processing of claims, or a social service, health or rehabilitative program.****DESCRIPTION
Professional work researching, developing, compiling, and rendering independent decisions relative to Social Security Disability Insurance, Supplemental Security Income and/or Medically Needy disability claims filed in the State of Florida
EXAMPLES OF WORK
1. Secures medical evidence of record needed to document the presence of a “disabling” or “non-disabling” impairment. 2. Utilizes effective telephone techniques to develop and/or establish necessary factual medical and vocational documentation. 3. Authorizes purchase of specialized medical or psychological diagnostic services, when appropriate, for the purpose of documenting the severity of impairment. 4. Evaluates a variety of documents to determine their evidentiary sufficiency for decision making purposes. 5. Renders a formal decision of disability based on evidentiary requirements of Social Security law, rules and regulations.
EXAMPLES OF JOB CHARACTERISTICSGetting Information Needed to Do the Job Observing, receiving, and otherwise obtaining information from all relevant sources. Documenting/Recording Information Entering, transcribing, recording, storing, or maintaining information in either written form or by electronic/magnetic recording. Communicating With Persons Outside of the Organization Communicating with persons outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged face-to-face, in writing, or via telephone/electronic transfer. Analyzing Data or Information Identifying underlying principles, reasons, or facts by breaking down information or data into separate parts. Evaluating Information Against Standards Evaluating information against a set of standards and verifying that it is correct. Judging Qualities of Things, Services, People Making judgments about or assessing the value, importance, or quality of things or people. Making Decisions and Solving Problems Combining, evaluating, and reasoning with information and data to make decisions and solve problems. These processes involve making decisions about the relative importance of information and choosing the best solution. Processing Information Compiling, coding, categorizing, calculating, tabulating, auditing, verifying, or processing information or data. Communicating With Other Workers Providing information to supervisors, fellow workers, and subordinates. This information can be exchanged face-to-face, in writing, or via telephone/electronic transfer. Identifying Objects, Actions, and Events Identifying information received by making estimates or categorizations, recognizing differences or similarities, or sensing changes in circumstances or events.
EXAMPLES OF KNOWLEDGE, SKILLS AND ABILITIES 1. Knowledge of the principles and techniques of effective verbal and written communication. 2. Knowledge of anatomy, physiology, function, dysfunction, and disease processes. 3. Knowledge of computer operation. 4. Ability to review data based on established guidelines for the purpose of determining eligibility for services of benefits. 5. Ability to understand and apply applicable rules, regulations, policies and procedures relating to services or benefits. 6. Ability to conduct fact finding research. 7. Ability to evaluate data for accuracy and completion, identify errors or problems and take appropriate corrective action.
LICENSURE, CERTIFICATION OR REGISTRATION REQUIREMENTS
EFFECTIVE 7/01/02
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The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. Applicants requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or the People First Service Center (1-877-562-7287). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. Veterans' preference will be given to eligible veterans and their spouses in accordance with Chapter 295 of the Florida Statutes.
Requirements:
Closest Major City
Jacksonville
Occupation
CLAIMS ADJUSTER, EXAMINER & INVESTIGATOR
Education
Bachelors (or equivalent work experience)
Job Type
Full Time
Region/County
Duval County
Years of Experience
1-3 years
Percent of Travel
1-25%