Disability Examiner II

Employment Benefits

Comprehensive medical, mental, dental, vision, and additional coverage

Sick & Vacation leave

Work-Life Balance programs : parental leave, military leave, jury leave, funeral leave

Paid State Holidays (designated by the Governor annually)

Fitness Centers in select locations

Employee discounts with the  STAR Program

Retirement and deferred compensation programs

Visit the Employee Benefits page for more information…

Position Summary & Responsibilities

Position Summary :

The position (K0221856)

This department adjudicates disability cases for persons applying for KanCare benefits. Medical background is preferred : Medical records, terminology, or medical office experience or course work. Organization and time management skills are key. Attention to detail and accuracy are critical.

Review medical, psychological, and vocational evidence and make an assessment of the applicant’s mental and physical functioning based on Social Security and State of Kansas guidelines. Create written case summary for contracted physician or psychologist review.Clarify and address inconsistencies in medical or psychological opinion, vocational factors or other inconsistencies in the file. Judge whether the applicant’s disability continues or has ceased.Apply program knowledge to overall case evidence and determine decision. Create formal written disability determination and rationalize the legal decision.

Demonstrate independent adjudication of all case types including expedited cases for individuals that are re-integrating from a state mental hospital & inmates that were hospitalized or soon to be releasing from KDOC custody. Utilize knowledge of SSA disability and medical conditions to analyze medical files of applicants applying for the State of Kansas Medicaid program to ensure the medical disability claimed is within the State of Kansas and Social Security Administration guidelines. Complete case adjudication. Completes vocational assessments for appropriate claims. Journalizes all medical decisions and collaborates with Social Security doctors on federally funded cases. Review medical files of children’s cases that do not meet criteria for other state medical programs and apply a specialized set of rules to determine medical disability. May recommend consultative exams.

Job Responsibilities may include but are not limited to the following :

Review initial and reconsideration disability claims to develop a plan of action. Review previously adjudicated claims for errors and make corrections. Obtain or advise others to obtain specific medical and psychological evidence and vocational information. Analyze complex medical, psychological, and vocational material and technical documents to determine additional materials required to make a determination, overturn decisions, or process other high-level claims. Identify the need for special medical or psychological studies and sometimes authorize the expenditure of program funds to obtain these.

Qualifications

• Education : High School, GED
• Licensing & Certification : Valid Driver's License - Incumbent is required to have and maintain a valid driver's license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State.
• Minimum Qualifications : Four years of experience interviewing, investigating, compiling information, documenting decisions, interpreting guidelines and / or providing technical assistance relevant to the agency's programs. Post secondary education may be substituted for experience as determined relevant by the agency.
• Preferred Qualifications : Bachelor’s degreeWord, Excel, PowerPoint, AccessProofreading, editing, attention to detailEffective verbal and written communicationKnowledge of medical terminologyCompleted the DDS disability examiner basic training1 year experience adjudicating disability casesOne year of case development or case research experience