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disability examiner resume example with 15+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Professional Summary

Throughout my entire career, I have always approached my work from the perspective that I am there to help my clients through a difficult time in their life by applying applicable programs with a sprinkle of advocacy when necessary.

Skills
  • The "go-to" person for working with and maintaining a helpful, accountable and positive customer service interaction with clients known to be challenging. Advanced knowledge and experience in eligibility determination.
  • Advanced knowledge and experience in interpreting medical records, medical diagnosis, and condition severity.
  • Advanced education, and experience in social problems, cultural and human behavior.
  • Detailed knowledge and experience with federal and state, social and medical services laws, rules, regulations, policies and procedures.
  • Detailed knowledge of community based and state and federal assistance programs.
  • Excellent written and verbal communication skills.
  • Detail oriented, with excellent time management and multitasking skills in high caseload, demanding work environment.
Education
University of North Dakota Grand Forks, ND, Expected in No Degree : General Studies - GPA :

Focused on completing general education requirements and core classwork while working two jobs.

University of Great Falls Great Falls, MT, Expected in 12/2005 Bachelor of Science : Sociology - GPA :
  • Achieved minors in Criminal Justice and Addiction Counseling.
  • Dean's List Fall and Spring Semesters of 2002, 2003, 2004, and 2005.
  • Worked part-time as Indian Child Welfare Act expert witness.
Work History
Department Of Administrative Services, State Of Ohio - Disability Examiner
Athens, OH, 08/2012 - Current

Generally responsible for developing, administering and implementing all elements of Montana's disability retirement program for all state, county, municipal, fire, police, highway patrol, sheriff, wildlife management, and judicial Public Employees in the state. More specifically, my responsibilities include:

  • Review medical records, treating physician diagnosis and contracted consultant medical experts analysis to determine and interpret disability severity and limitations.
  • Synthesize case medical documents, physician and contracted consultant technical information into a written case summary including staff recommendation for Montan Public Employees Retirement Association (MPERA) Board consideration and action.
  • Work closely with legal counsel on disputed cases.
  • Participate in revising and drafting statute, rule and policy.
  • Present cases to MPERA Board at form Board meetings.
  • Prepared and administered contracts for professional medical consultant services.
  • Provide excellent customers service to Public Employees seeking information and assistance on disability benefits offered through MPERA.
  • Apply complex mathematical formulas to calculate and predict retirement benefits.
  • Guide members though the Disability application process.
  • Well versed and frequently interpret and synthesize state and federal statute, rule, policy, legal precedent, and other factors to determine and coordinate applicable disability benefits.
  • Conducted day-to-day administrative tasks and use Public Employees Retirement Information System and Laser Fishe software programs to maintain information files and process paperwork in compliance with Health Insurance Portability and Accountability Act (HIPAA), American Disability Act (ADA), and state statute, rule and policy.
Colliers International - Disability Claims Adjudicator
Charlottesville, VA, 05/2009 - 08/2012

Generally responsible for making medical and/or psychological decisions on eligibility and continuing eligibility for Social Security and Supplemental Security Income claims for the United States Social Security Administration.

Specific responsibilities include:

  • Review initial and reconsideration claims and applications as well as Continuing Disability Review Reports for both adults and children and determined what medical/vocational/educational information was needed.
  • Requested information from applicants by telephone or U.S. Mail as necessary to meet disability program requirements.
  • Contact physicians, psychologists, other health care professionals and educational institutions to obtain information regarding claimants physical and mental condition.
  • Analyze data, including diagnostic and assessment tests, for program requirements.
  • Order medical and psychological examinations and tests to help determine severity of applicants' physical and mental impairment.
  • Evaluate previous vocational history to evaluate ability to perform past work and/or if claimant has transferrable skills ot other work activity.
  • Use Social Security evaluation forms and considers all medical, psychological, vocational and/or educational records to establish program eligibility, in consultation with DDS Medical Psychological Consultants, Disability Program Specialists (QA) and Disability Program Managers.
  • Explain program eligibility and interpret medical and vocational information for claimants, their legal representatives, Social Security Administration officials and other interested parties.
  • Compose technical explanations of decisions and personalized notification to applicant regarding program eligibility.
  • Maintain current knowledge of applicable federal rules and regulations.
State Of Montana - Office Of Public Assistance - Client Services Coordinator
City, STATE, 01/2006 - 05/2009

Generally responsible for collect managing, prioritizing and maintaining all necessary documentation to determine eligibility and assist clients with enrollment in multiple social assistance programs including Temporary Assistance for Needy Families (TANF Cash), United States Department of Agriculture Food Stamps, Family and Nursing Home Medicade, Children's Health Insurance Program (CHIP) under Medicade, and Medicare. More specifically my responsibilities included:

  • Managing a ~400 client caseload while maintaining excellent customer service.
  • Communicating policies and procedures to a diverse client-based in-person or via the Public Assistance helpline.
  • Conducting interviews to obtain necessary information for determining and processing eligibility.
  • Applying a variety of complex state and federal laws, policies, and processes pertaining to eligibility determination.
  • Documenting case changes such as household circumstances, file transfers, program policies, and decision changes.
  • Monitoring and redetermine eligibility and ensuring benefits accuracy and program compliance.
  • Establishing re-payment plans with clients, identifying suspected fraud, and referring cases for formal investigation.
  • Implementing results from quality control reviews including recalculating benefit eligibility.

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Resume Overview

School Attended

  • University of North Dakota
  • University of Great Falls

Job Titles Held:

  • Disability Examiner
  • Disability Claims Adjudicator
  • Client Services Coordinator

Degrees

  • No Degree
  • Bachelor of Science

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