You are reading the State of New Jersey Job Descriptions. This is not a Job Vacancy Announcement.

Job Specification

  CLAIMS ADJUDICATOR TRAINEE DISABILITY DETERMINATIONS


  DEFINITION:

  Under direction of a supervisory official, as a trainee and
  productive worker, reviews applications and develops medical and
  nonmedical data to make determinations of disablility in accordance
  with the provisions of the Social Security Disability and Supplemental
  Security Income Disability Programs; assists in the processing and
  closing of other types of insurance claims according to applicable
  state laws as required; documents decisions by selective development of
  vocational or other data; does related work as required.

  NOTE: The examples of work for this title are for illustrative
  purposes only.  A particular position using this title may not
  perform all duties listed in this job specification.  Conversely,
  all duties performed on the job may not be listed.

  NOTE: Appointments may be made to positions requiring 
  bilingual skills.

  64951C - Bilingual in Spanish and English 
  SPECIAL SKILL
  Applicants must be able to read, write, speak, understand, or 
  communicate in Spanish and English sufficiently to perform 
  the duties of this position.


  EXAMPLES OF WORK:

  As a trainee and productive worker:

  Assists in reviewing cases referred by Social Security District
  Offices or insurance carriers and prepares a work sheet of the case
  containing demographic characteristics, available medical evidence, 
  and such nonmedical evidence as substantial gainful activity engaged
  subsequent to the alleged onset date.

  Obtains additional medical data, as recommended by the review
  physician; obtains nonmedical data, including data relating to vocational
  factors, when so required, from applicants, treating physicians,
  hospitals and clinics.

  Evaluates applicants' work records and verifies the alleged onset
  date of disability.

  Contacts claimants to obtain their written permission to obtain
  additional medical evidence.

  Assists in reviewing medical evidence and in determining the
  extent of an individual applicant's disability in accordance with the
  medical guides furnished by the Social Security Administration.

  Confers with review physicians to determine residential functional
  limitations and capacities as they relate to claimant's ability to
  return to his or her former employment.

  Makes full use of available community resources, including the
  Veterans Administration, Vocational Rehabilitation Services, and
  Employment Services local offices, as required.

  Assists in reviewing and evaluating case data and, after conferring 
  with review physician for his concurrence, may prepare case
  determination for transmittal to the Baltimore Regional Office of the
  Social Security Administration.

  Maintains essential records and files.

  Will be required to learn to utilize various types of electronic
  and/or manual recording and computerized information systems 
  used by the agency, office, or related units.


  REQUIREMENTS:

       EDUCATION:

  Graduation from an accredited college or university with a
  Bachelor's degree.

       LICENSE:

  Appointees will be required to possess a driver's license
  valid in New Jersey only if the operation of a vehicle, rather than
  employee mobility, is necessary to perform the essential duties 
  of the position.


  KNOWLEDGE AND ABILITIES:

  Ability to understand current trends in the theories of social
  insurance, especially disability insurance.

  Ability to gain the confidence of general practitioners, medical
  specialists, and others, in order to elicit necessary case information
  leading to determinations of eligibility.

  Ability to profit by an inservice training program.

  Ability to comprehend, analyze, and interpret basic legislation,
  regulations, and procedures.

  Ability to comprehend and interpret medical evidence in support 
  of diagnoses and use these data to make determinations of eligibility 
  in accordance with standards developed by the Social Security
  Administration.

  Ability to review and analyze cases to determine the adequacy 
  and currency of medical and related nonmedical data.

  Ability to prepare clear, sound, accurate, and informative case
  histories containing determinations of disability.

  Ability to maintain essential records and files.

  Ability to learn to utilize various types of electronic and/or
  manual recording and information systems used by the agency, 
  office, or related units.

  Ability to read, write, speak, understand, or communicate in
  English sufficiently to perform the duties of this position.  American
  Sign Language or Braille may also be considered as acceptable 
  forms of communication.

  Persons with mental or physical disabilities are eligible as long
  as they can perform essential functions of the job with or without
  reasonable accommodation.  If the accommodation cannot be 
  made because it would cause the employer undue hardship, 
  such persons may not be eligible.

  ADVANCEMENT:

  Applicants who complete the twelve-month (12) training period
  successfully will be eligible for advancement to the title:  Claims
  Adjudicator, Disability Determinations.

  The inability of an employee in this title to attain a level
  of performance warranting advancement to the title listed above 
  shall be considered as cause for separation.

This job specification is applicable to the following title code(s) which
are different work week or work month and/or variants of the job class title:
Job
Spec
Code
VariantState,
Local or
Common
Class of
Service
Work
Week
State
Class
Code
Local
Class
Code
Salary
Range
Note
64951SC3595N/AP95-
64951CBilingual In Spanish And EnglishSC3595N/AP95-

This job specification is for state government use only.
Salary range is only applicable to state government.
Local salaries are established by individual local jurisdictions.

5/8/2010