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Health & Human Services

Disability Call Agent

Career Insights for Claims Examiner (General)

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Based on North Carolina data

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What they do

A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.

$78,502 / year median in North Carolina

+4% projected growth

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Job Description

Agency Dept of Health and Human Services Division Disability Determination Services Job Classification Title Administrative Specialist I (S) Position Number 60055757 Grade NC08 About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence. Description of Work The NC Disability Determination Services (DDS) is located in Raleigh, NC and is the state division responsible for making medical determinations on disability claims for the Social Security Administration and state Medicaid office. The division adjudicates over 140,000 initial disability applications, reconsiderations, reviews for continuing eligibility, and continuing disability review appeals under the Social Security and Supplemental Security Income program and disability applications for Medicaid. Applications are forwarded to Disability Determination Services (DDS) from local Social Security offices or in the case of Medical Assistance claims, from the County Department of Social Services. Agency personnel are responsible for obtaining medical and vocational information on applicants, evaluating the findings under Social Security Administration (SSA) disability criteria and preparing determinations and notices to advise the Applicant of the decision on the claim. The Disability Call Agent (DCA) is responsible for answering incoming phone calls to the Disability Contact Center (Inbound Call Center). The Disability Contact Center is the first level of contact for the external customer. The representative is responsible for responding to the needs and questions and providing information to external customers. The representative uses their scope of knowledge to assist and resolve issues. Eligible DCAs are able to take advantage of a hybrid telework schedule. This position is located in the Disability Contact Center within DDS. The DCA will independently manage high call volume from claimants, schools, SSA Field offices, and others in the medical and legal communities. The DCA will handle calls with courtesy and professionalism when responding to customer inquiries and will adhere to the Disability Contact Center Policies. The DCA is responsible for communicating relevant information for each contact to the appropriate persons in accordance with DCC guidelines. The DCA is responsible for planning and organizing tasks so that deadlines are met, providing accurate and complete information to internal and external customers, and determining when it is necessary to involve adjudicators, supervisors and managers. The DDS offers a work environment that promotes the values of DHHS. The DDS offers free parking, has an in-house Micromart for food purchases and a small in-house Wellness Room with exercise equipment. There are nearby stores and dining options. We work to ensure staff feel they belong as a team member of the DDS while we work to provide excellent customer service to our citizens. Knowledge Skills and Abilities/Management Preferences Internal Posting

•DHHS Internal Posting

•This Is An Internal Posting Open Only For Current North Carolina Department Of Health And Human Services Employees, And Eligible RIF Candidates From North Carolina State Government, or Current Temporary Employees. This recruitment is to fill three vacant positions: 60055552, 60055757, 65009523

Salary Range:

$39,244

•$68,679 Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement. The Knowledge Skills and Abilities/ Management Preferences are not required. Applicants who possess the following skills are preferred. Demonstrated experience in written and oral communication with individuals from varying backgrounds. Demonstrated experience in switching between multiple tasks Call center experience This position is funded in part through federal funds. This position will close at 11:59 p.m. the night before the end date. The NC Disability Determination Services (DDS) is located in Raleigh, NC and is the state division responsible for making medical determinations on disability claims for the Social Security Administration and state Medicaid office. The division adjudicates over 140,000 initial disability applications, reconsiderations, reviews for continuing eligibility, and continuing disability review appeals under the Social Security and Supplemental Security Income program and disability applications for Medicaid. Applications are forwarded to Disability Determination Services (DDS) from local Social Security offices or in the case of Medical Assistance claims, from the County Department of Social Services. Agency personnel are responsible for obtaining medical and vocational information on applicants, evaluating the findings under Social Security Administration (SSA) disability criteria and preparing determinations and notices to advise the Applicant of the decision on the claim.

Compensation & Benefits:

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees. Visit website for State Benefits Supplemental and Contact Information The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about

DHHS:

https://www.ncdhhs.gov/. DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position. In accordance with the Governor's Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified. Application Process Be sure to complete the application in its entirety. Resumes will not be accepted in lieu of completing this application. Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information. Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application to support your answers. Applicants may be subject to a criminal background check. All candidates selected for positions considered "Positions of Trust" will be subject to a criminal background check. Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. Upon the closing date, applications are "Under Review" and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks. Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent. For a list of organizations that perform this specialized service, please visit the NACES membership website at https://www.naces.org/members. Degree/College Credit Verification Degrees must be received from appropriately accredited institutions. Transcripts, degree evaluations and cover letters may be uploaded with your application. Veterans' and National Guard Preference Applicants seeking Veteran's Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications. Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing. Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of the DD 256 or NGB 22, along with the state application. ADA Accommodations Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.

CONTACT INFORMATION

If there are any questions about this posting, please contact Talent Acquisition at talentacquisition@dhhs.nc.gov. Resumes will not be accepted in lieu of completing this application. Minimum Education and Experience Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details. High school diploma or General Educational Development (GED) diploma and two years of related administrative experience. OR Equivalent combination of education and experience. EEO Statement The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.

Recruiter:
LaWanna Baker Email:

talentacquisition@dhhs.nc.gov North Carolina State Government is one of the state's largest employers, with over 76,000 employees all working toward a common goal: a safer and stronger North Carolina. We are a large organization comprised of various agencies, offices, and universities, each providing important public services. Eligible state employees are entitled to comprehensive benefits, including a variety of leave options, professional development opportunities, insurance, and more. To learn more about the benefits of being a North Carolina state employee, visit the N.C. Office of State Human Resources' website. Permanent, temporary, and time-limited state government jobs can be found from the mountains to the coast. Find your next opportunity today! State Application Resources/Frequently Asked Questions Valuing Education and Experience The State of North Carolina values the knowledge and experience of our jobseekers and current state employees. Approximately 91 percent of state job classifications allow experience to be substituted for education or do not require a post-secondary degree. Learn more about how you may qualify for a position through education or directly related experience, or a combination of both, with the Education and Experience Equivalency Guide. All job postings close at 11:59pm the night before the End Date on the posting. Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match. If you are already a state employee, please search for jobs by clicking here.