STATE CLASSIFICATION JOB DESCRIPTION
Salary Group B18	Class No. 2923

CLAIMS EXAMINER III

GENERAL DESCRIPTION

Performs highly complex (senior-level) disability determination work. Work involves reviewing case histories, evaluating data, conducting investigations, and preparing disability determinations. May supervise the work of others. Works under limited supervision with considerable latitude for the use of initiative and independent judgment.

EXAMPLES OF WORK PERFORMED

Reviews requests for appeal actions, evaluates available material, secures necessary evidence, prepares supporting documentation, and affirms or revises determinations.

Participates in program planning.

Develops physical or mental developmental assessments.

Develops and conducts presentations.

Identifies and reports cases involving potential fraud.

Arranges for consultative examinations to develop sufficient evidence to adjudicate claims, and obtains medical or vocational review of evidence.

Assesses the residual functional capacity and ability to perform past relevant work as a result of alleged impairments.

May develop policies and procedures.

May supervise the work of others.

Performs related work as assigned.

GENERAL QUALIFICATION GUIDELINES

Experience and Education

Experience in disability determination work. Graduation from an accredited four-year college or university with major course work in social work or a related field is generally preferred. Experience and education may be substituted for one another.

Knowledge, Skills, and Abilities

Knowledge of applicable laws and regulations concerning disability determination, and of medical and psychological terminology.

Ability to prepare determinations, to apply and explain relevant laws, to analyze documents, to prepare correspondence, to communicate effectively, and to supervise the work of others.

State Auditor’s Office

Revised 9-1-09