Pre-Development Specialist / Claims Examiner I
Austin, TX Austin, TX Full-time Full-time $3,576 - $4,345 a month $3,576 - $4,345 a month 10 days ago 10 days ago 10 days ago The Pre-Development Specialist (PDS) maintains and monitors a caseload of Social Security Administration (SSA) adult and childhood disability cases in SSA's Disability Case Processing System (DCPS) that are not yet assigned to a Disability Specialist.
Uses knowledge of the SSA Sequential Evaluation process to assist Disability Specialists by initiating disability cases and obtaining documentation required to determine whether a claimant is disabled.
Researches and identifies Disability Determination Services (DDS) jurisdiction and returns to SSA any cases DDS is proscribed from processing.
Generates outbound calls to confirm, obtain, or clarify information needed and uses DCPS to create forms, letters, and supporting materials required to document disability determinations.
Routinely creates letters and forms to solicit medical evidence of record (MER), activities of daily living (ADL) information, detailed descriptions of past relevant work (PRW), education records and teacher evaluations on child claimants, and other information required to evaluate disability and properly document the case file.
Takes ADL and/or work history information over the phone to assist in full case development and provide expected level of customer service.
Order Consultative Examinations (CE), with approval, to investigate undocumented claimant allegations and/or clarify medical evidence.
Responds to inquiries from claimants, medical providers, independent school district officials, and SSA field office staff.
Works under moderate supervision with limited latitude for the use of initiative and independent judgment.
This position occasionally requires work during the weekends, holidays, and before or after normal business hours.
DDS employees perform all business functions for SSA using the federal SSA network and equipment.
Homeland Security Presidential Directive (HSPD)-12 security clearance is required.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Maintains and manages a caseload of child and adult disability cases not yet assigned to a Disability Specialist, initiating action on cases assigned with the specified timeframes and handling calls from claimants, appointed representatives, medical providers, schools, SSA offices, and other external contacts.
Maintains relevant knowledge necessary to ensure all case initiation actions are complete and compliant with SSA and DDS policies and procedures.
Documents in DCPS the actions taken to include any information received directly from the claimant or other source during initiation.
Generates outbound calls to confirm, obtain, or clarify information and uses DCPS to create forms, letters, and supporting materials required to document disability determinations.
Contacts relevant sources for MER based on the claimant's reported medical conditions and impairments and obtains functional and work history information about claimants.
Order Consultative Examinations (CE), with approval, to clarify evidence and properly document the impairments and the claimant's current condition.
Reviews all file documentation upon receipt of disability cases, researching and investigating case information that may affect DDS jurisdiction, case assignment prioritization, or indicate potential Presumptive Disability/Presumptive Blindness eligibility.
Provides prompt notification to the unit manager of jurisdictional issues and/or case situations that require immediate action.
Returns cases that are not DDS jurisdiction to SSA for correction or closure without initiating case development.
Prepares appropriate documentation for SSA field office staff to explain jurisdictional issues and/or actions needed.
Establishes standards for customer-focused communication and coordination within areas of responsibility and with all internal and external associates and customers.
Performs other duties as assigned, including but not limited to training and mentoring other PDSs.
Provides backup for absent Pre-Development Specialists (PDSs) in accordance with established procedures.
Knowledge Skills Abilities:
Knowledge and application of SSA (Social Security Administration) and DDS (Disability Determination Services) regulations, policies, and procedures for processing and documenting disability cases.
Knowledge and application of Federal and State laws governing confidentiality of personal information.
Knowledge of medical and psychological conditions, terminology, and abbreviations to ensure correct and complete development of case evidence.
Knowledge of, and ability to interpret and implement, SSA, HHS, and DDS disability and administrative regulations, policies, and procedures.
Skill in effective oral and written communication.
Skill in using standard office equipment and software as well as Social Security Administration software applications.
Skill in managing time, organizing job-related responsibilities, and meeting deadlines independently.
Skill in adapting to program changes and fluctuating workloads.
Ability to establish and maintain effective working relationships.
Registration or Licensure Requirements:
None Initial Selection Criteria:
Must have a high school diploma or GED with at least two years of work experience in an office and/or customer service setting.
College coursework completed after attaining the high school diploma or GED may be combined with, or substituted for, work experience on a year-for-year basis.
Must exhibit a stable work history.
Must demonstrate experience using a personal computer.
Additional Information:
Applicants may not have a history of substantiated fraudulent activity against HHSC or any programs it administers.
Applicants who have anon-fraud overpayment with an outstanding balance must agree to repay the overpayment balance as a condition of employment.
This position occasionally requires work during the weekends, holidays, and before or after normal business hours.
Individuals selected for positions with the Disability Determination Service (DDS) will go through a complete federal background investigation.
A suitability determination by the Social Security Administration is necessary to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems.
The job offer is contingent upon a full suitability clearance through SSA.
Applicants will be assessed through a panel interview.
Consideration will be given to filling additional vacancies that occur during this posting period.
Demonstration of skill will be administered at the time of interview.
Individuals with the same FJD may not apply.
Any employment offer is contingent upon available budgeted funds.
The offered salary will be determined in accordance with budgetary limits, follow HHS salary administration policy and guidelines and based on the candidate's qualifications.
This position may be eligible for a hybrid remote telework schedule if requirements are met and based on the agency's business needs.
MOS Code:
Note:
There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position.
All active duty, reservists, guardsmen, and veterans are encouraged to apply.
For more information, see the Texas State Auditor's Military Crosswalk on HHSC' Veterans Resources page, State Mandated Requirements (Excel Spreadsheet link).
Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS HHS agencies use E-Verify.
You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability.
If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747.
If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
Uses knowledge of the SSA Sequential Evaluation process to assist Disability Specialists by initiating disability cases and obtaining documentation required to determine whether a claimant is disabled.
Researches and identifies Disability Determination Services (DDS) jurisdiction and returns to SSA any cases DDS is proscribed from processing.
Generates outbound calls to confirm, obtain, or clarify information needed and uses DCPS to create forms, letters, and supporting materials required to document disability determinations.
Routinely creates letters and forms to solicit medical evidence of record (MER), activities of daily living (ADL) information, detailed descriptions of past relevant work (PRW), education records and teacher evaluations on child claimants, and other information required to evaluate disability and properly document the case file.
Takes ADL and/or work history information over the phone to assist in full case development and provide expected level of customer service.
Order Consultative Examinations (CE), with approval, to investigate undocumented claimant allegations and/or clarify medical evidence.
Responds to inquiries from claimants, medical providers, independent school district officials, and SSA field office staff.
Works under moderate supervision with limited latitude for the use of initiative and independent judgment.
This position occasionally requires work during the weekends, holidays, and before or after normal business hours.
DDS employees perform all business functions for SSA using the federal SSA network and equipment.
Homeland Security Presidential Directive (HSPD)-12 security clearance is required.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Maintains and manages a caseload of child and adult disability cases not yet assigned to a Disability Specialist, initiating action on cases assigned with the specified timeframes and handling calls from claimants, appointed representatives, medical providers, schools, SSA offices, and other external contacts.
Maintains relevant knowledge necessary to ensure all case initiation actions are complete and compliant with SSA and DDS policies and procedures.
Documents in DCPS the actions taken to include any information received directly from the claimant or other source during initiation.
Generates outbound calls to confirm, obtain, or clarify information and uses DCPS to create forms, letters, and supporting materials required to document disability determinations.
Contacts relevant sources for MER based on the claimant's reported medical conditions and impairments and obtains functional and work history information about claimants.
Order Consultative Examinations (CE), with approval, to clarify evidence and properly document the impairments and the claimant's current condition.
Reviews all file documentation upon receipt of disability cases, researching and investigating case information that may affect DDS jurisdiction, case assignment prioritization, or indicate potential Presumptive Disability/Presumptive Blindness eligibility.
Provides prompt notification to the unit manager of jurisdictional issues and/or case situations that require immediate action.
Returns cases that are not DDS jurisdiction to SSA for correction or closure without initiating case development.
Prepares appropriate documentation for SSA field office staff to explain jurisdictional issues and/or actions needed.
Establishes standards for customer-focused communication and coordination within areas of responsibility and with all internal and external associates and customers.
Performs other duties as assigned, including but not limited to training and mentoring other PDSs.
Provides backup for absent Pre-Development Specialists (PDSs) in accordance with established procedures.
Knowledge Skills Abilities:
Knowledge and application of SSA (Social Security Administration) and DDS (Disability Determination Services) regulations, policies, and procedures for processing and documenting disability cases.
Knowledge and application of Federal and State laws governing confidentiality of personal information.
Knowledge of medical and psychological conditions, terminology, and abbreviations to ensure correct and complete development of case evidence.
Knowledge of, and ability to interpret and implement, SSA, HHS, and DDS disability and administrative regulations, policies, and procedures.
Skill in effective oral and written communication.
Skill in using standard office equipment and software as well as Social Security Administration software applications.
Skill in managing time, organizing job-related responsibilities, and meeting deadlines independently.
Skill in adapting to program changes and fluctuating workloads.
Ability to establish and maintain effective working relationships.
Registration or Licensure Requirements:
None Initial Selection Criteria:
Must have a high school diploma or GED with at least two years of work experience in an office and/or customer service setting.
College coursework completed after attaining the high school diploma or GED may be combined with, or substituted for, work experience on a year-for-year basis.
Must exhibit a stable work history.
Must demonstrate experience using a personal computer.
Additional Information:
Applicants may not have a history of substantiated fraudulent activity against HHSC or any programs it administers.
Applicants who have anon-fraud overpayment with an outstanding balance must agree to repay the overpayment balance as a condition of employment.
This position occasionally requires work during the weekends, holidays, and before or after normal business hours.
Individuals selected for positions with the Disability Determination Service (DDS) will go through a complete federal background investigation.
A suitability determination by the Social Security Administration is necessary to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems.
The job offer is contingent upon a full suitability clearance through SSA.
Applicants will be assessed through a panel interview.
Consideration will be given to filling additional vacancies that occur during this posting period.
Demonstration of skill will be administered at the time of interview.
Individuals with the same FJD may not apply.
Any employment offer is contingent upon available budgeted funds.
The offered salary will be determined in accordance with budgetary limits, follow HHS salary administration policy and guidelines and based on the candidate's qualifications.
This position may be eligible for a hybrid remote telework schedule if requirements are met and based on the agency's business needs.
MOS Code:
Note:
There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position.
All active duty, reservists, guardsmen, and veterans are encouraged to apply.
For more information, see the Texas State Auditor's Military Crosswalk on HHSC' Veterans Resources page, State Mandated Requirements (Excel Spreadsheet link).
Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS HHS agencies use E-Verify.
You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability.
If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747.
If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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