Public Consulting Group

Initial/Reconsideration Level - Claim Developer

Job Locations US-WA-Clarkston | US-NY-Troy
Posted Date 2 months ago(7/23/2021 2:00 PM)
Job ID
2021-6867
# of Openings
2
Category
Operation Support
Type
Regular Full-Time
Practice Area
Human Services

Overview

About Public Consulting Group

Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Human Services practice helps state, county, and municipal human services agencies to achieve their performance goals in order to better serve populations in need. PCG’s seasoned professionals offer proven solutions to help agencies design programs, services, and systems; increase program revenue; cut costs; and improve regulatory compliance with state and federal regulations. To learn more, visit http://www.publicconsultinggroup.com/humanservices/.

 

       Social Security Advocacy Management Service SSAMS™:

 

PCG’s SSAMS™ team provides comprehensive technology driven Social Security disability identification and advocacy services.  Our work encompasses contracts with public sector child welfare, TANF, Medicaid, and private sector individuals and pension/retirement plan agencies to identify and enroll disabled individuals onto Social Security’s Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) programs.

 

PCG SSAMS™ provides advocacy services for Orange County, California, Social Services Agency (SSA), assisting hard to serve individuals with medical and/or mental health impairments, and who may qualify for federal benefits, in applying for and obtaining SSI, SSDI and, State Supplementary Payment (SSP). These programs are designed to promote employment opportunities and self-sufficiency.  PCG assists potentially eligible CalWORKs/GR clients with the application process for SSI/SSP and SSDI benefits, including providing representation for claims pending at the Social Security Administration from the initial level through the hearing and appeals level.

Responsibilities

The IRC Developer is responsible for the development of SSI/SSDI applications at the initial and reconsideration level of the Social Security Administration’s (SSA) disability adjudication process.  IRC Developers are assigned claims after they have been filed with SSA. Their objective is to develop cases to ensure the highest likelihood of an award. Their responsibilities include:

  • Conduct a review of all newly assigned claims to get familiarized with the case and identify strengths and weaknesses.
  • Identify and request needed medical, educational, and vocational evidence that supports the alleged disability.
  • Submit medical, educational, and vocational evidence to Disability Determination Services (DDS).
  • Maintain regular contact with claimant to provide status updates, collect information on new or changing conditions related to their disability, confirm Consultative Exam (CE) appointments, and provide general customer service.
  • Maintain regular contact with SSA and DDS to obtain status updates or assist them in collecting data or evidence.
  • Review Notice of Award with claimant.

If a claim is denied:

  • ·       Review decision to determine the cause for the denial and confirm that DDS considered all evidence.
  • ·       Collect any new evidence, if available.
  • ·       Review case with the Team Lead to gain their assessment on whether to appeal or close the claim.
  • ·       If decided by the Team Lead to file an appeal, complete all forms to submit an appeal.
  • ·       Claims that are being appealed to the hearings level will be transitioned to a Hearings Analyst.

At all times, the SSAMS Case Management system must be kept up to date, contain accurate data, and clear and detailed notes.  The IRC Developer will follow defined policy and procedures and meet specified processing times and deadlines.

 

Qualifications

       Required Skills:

 

 

  • Intermediate skill with Microsoft office products
  • Strong written and verbal communication skills
  • Strong Interpersonal skills, including the ability to establish working relationships with federal, state and county agencies as well as the public.
  • Ability to recognize and maintain confidentiality of all materials in the work setting.
  • Knowledge and understanding of SSA’s adjudication process.
  • Knowledge and understanding of SSA’s medical, psychological, and vocational criteria.
  • Knowledge and understanding of the relationship between SSI/SSDI and Medicaid/Medicare
  • Ability to understand and follow defined business processes in conducting the work.

 

 
  
  
  
  

 

Education:

A Bachelor’s degree or 3 years of relevant experience

Experience:

Social Security disability advocacy, human service, or health related fields

Certification:

SSI/SSDI Outreach, Access, and Recovery (SOAR) certified (can obtain post-employment).

#LI-MB1

EEO Statement

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Public Consulting Group!

Not ready to apply? Connect with Public Consulting Group for general consideration.