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Disability Examiner resume examples

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Skills

  • MS Office
  • Operational improvement
  • Claimant Documentation Retrieval
  • Appeals Case Reduction
  • Conflict resolution and mediation
  • Regulatory compliance
  • Decision Justification Drafting
  • Time management
  • Medical terminology proficiency
  • Medical-Vocational Case Analysis

Work Experiences

  • Analyzed legislative changes.
  • Looked for industry trends on social media and through online sources.
  • Reviewed original investigation reports and documents to address secondary concerns.
  • Analyzed legislative changes and developed updates for procedural guidance documents, improving adherence to current disability laws and regulations in 2015.
  • Awarded Employee of the Year for excellence in claim processing.
  • Based on clearly documented medical evidence.
  • Collaborated with physicians and vocational experts.
  • Authored resolution reports for 6 disability claims weekly.
  • Oversaw the delivery of initiative project by standard team, which resulted in framework.
  • Conducted agent and claimant interviews to review questionable claims to correct omissions and errors.

Summaries

  • Achieved a high satisfaction rate among claimants.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved timely and accurate disability reviews.
  • Committed to both balancing caseloads and maintaining accuracy, with a specialization in medical, vocational, and legal aspects of the SSA disability decision process.
  • Accomplished professional in disability determination.
  • Within Miscellaneous, senior Disability Examiner and outstanding performer in team leadership and vendor management.
  • Achieved faster case closure times.
  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved 30% improvement in decision-making timelines.

Accomplishments

  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Led a cross-functional team in revamping the case management system, accelerating case resolution time by 29% in 2020.
  • Worked with IT department to streamline the case management tracking system, resulting in a 72% increase in case resolution speed for process.
  • Resolved complex claimant issues involving medical and vocational disputes, improving public trust and decreasing rework cases by 18%.
  • Awarded President's Club for excellence in accurately interpreting disability claims and increasing adjudication speed by 47%.
  • Developed comprehensive procedural manuals for disability determination, standardizing processes and reducing case review discrepancies by 78%.
  • Created a quality assurance program to audit key steps in the disability review process, resulting in a 44% improvement in workflow consistency and accuracy.
  • Guided team in interpreting complex medical documentation, with a 75% reduction in misclassified cases, positively impacting departmental quality scores.
  • Performed high-quality review of medical and vocational evidence, consistently maintaining a 63% approval rating with external audit processes.
  • Initiated a claimant communication strategy that improved transparency, leading to a 56% year-over-year decrease in escalations to appeals.

Affiliations

  • International Disability Alliance (IDA)
  • American Medical Informatics Association
  • American College of Healthcare Executives (ACHE)
  • Health Care Compliance Association (HCCA)
  • National Council on Disability
  • Association for Supply Chain Management (APICS)
  • American Association of Healthcare Administrative Management (AAHAM)
  • SSA Disability Program Managers Association
  • Association of Information Technology Professionals
  • Society for Human Resource Management (SHRM) – Disability Inclusion Committee

Certifications

  • Legal and Insurance Disability Specialist (LIDS) - Cedar Works
  • Social Security Disability Advocate (SSDA) - Summit Group
  • Certified Professional Coder (CPC) - AAPC
  • Critical Skills in Disability Assessment Certificate - Lakeside Partners
  • Human Services Case Management Certification - Ironclad Systems
  • Fundamentals of Disability Benefit Systems - Harbor & Co.
  • Certified Legal Disability Specialist (CLDS) - Beacon Labs
  • Cisco Certified Network Associate (CCNA)
  • National Disability Navigator Credential - Brightline
  • Disability Claims Review Specialist Certification (DCRS) - Meridian

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