Medical Adjudicator Jobs (NOW HIRING)

Description DSHS ESA DDS Adjudicator 3 Duty station location: Olympia Every day, people across Washington wait to hear decisions about their Disability claim. Behind each claim is someone that can not work because of various reasons often outside of their control. This job will decide whether that person gets the support they requested.

DSHS's Disability Determination Services (DDS) operates under contract with the Social Security Administration. The division reviews claims for Social Security Disability Insurance, Supplemental Security Income, and DSHS Non-Grant Medical Assistance. Staff across the state's DDS offices process nearly 1,700 new claims a week.

As a DDS Adjudicator 3, you will review medical, vocational, and legal records for disability claims. You will look at the full picture of a person's health and work history, then write a clear decision explaining whether a claim is approved, denied, continued, or stopped. You will work independently, managing your own caseload from start to finish.

This work can be challenging, but it's rewarding. You'll help people get support when they need it most, while making sure state funds are allocated fairly and consistently. Please note: This position currently has the option to work a flexible/hybrid schedule, based on business needs, once Federal credentials have been successfully issued to the employee.

In-office training as well as travel may be required as the business needs arise. Some of what you'll do: Review Social Security Disability and State Non-Grant claims, including continuing disability reviews, age 18 redeterminations, and initial applications and reconsiderations. Gather and study medical, vocational, and legal records to understand each person's situation.

Decide when a claim needs more medical evidence and order the exams needed to make a fair decision. Confirm that all requested medical records are complete and flag any gaps or anomalies. Write clear decisions that explain whether a claim is approved, denied, continued, or stopped.

Set the date for the next review on claims that are approved or continued. Explain a claimant's rights, including the right to appeal a decision. Mentor and support newer adjudicators as opportunities arise.

Refer cases with signs of fraud to the Cooperative Disability Investigation Unit. Identify cases where drug or alcohol use affects a disability claim. Attend team meetings and required training to stay current on policies and procedures.

Who should apply. Those that meet the following criteria: Two years of successful experience as an adjudicator of Social Security Disability claims within the last 3 years. AND either: - a bachelor's degree.

OR -four or more years of professional experience working with disability, medical or insurance claims adjudication or investigation, health care, unemployment, workers compensation, social services, or related field. Equivalent education/experience. Additional knowledge, skills, and abilities we are looking for: Communication: Explains complex medical and legal information clearly, both in writing and verbally.

Analysis: Reads and interprets medical and vocational records accurately, then identifies what matters most to the decision. Judgment: Works through subjective or conflicting evidence and reaches a sound, well-supported conclusion. Composure: Handles disagreements and difficult conversations with professionalism.

Technology: Learns and confidently uses multiple case processing systems to manage an active caseload. Time management: Balances a full caseload against firm deadlines without sacrificing accuracy. Empathy: Responds to people in difficult situations with compassion, while staying objective and fair.

Equity: Applies consistent standards to every claim and treats each person with respect and empathy. interested. Apply today.

The Department of Social and Health Services' (DSHS) vision that people find human services to shape their own lives requires that we come together with a sense of belonging, common purpose, shared values, and meaningful work. It is crucial to our agency's vision that you bring a fairness, access, and social justice commitment to your work with DSHS. We strive to support all Washingtonians, including Black, Indigenous, and People of Color, people with physical, behavioral health, and intellectual disabilities, elders, LGBTQIA+ individuals, immigrants and refugees, and families building financial security.

Questions. Please contact DSHS Recruiter, Georgina Pringle, at Georgina.Pringle@dshs.wa.gov and reference job number 05897. Supplemental Information Prior to a new hire, a background check including criminal record history may be conducted

Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the job. This announcement may be used to fill multiple vacancies. Employees driving on state business must have a valid driver's license.

Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle. Washington State Department of Social and Health Services is an equal opportunity employer and does not discriminate in any area of employment, its programs or services on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protected veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information. Persons requiring accommodation in the application process or this job announcement in an alternative format may contact the Recruiter at (360) 725-5810.

Applicants who are deaf or hard of hearing may call through Washington Relay Service by dialing 7-1-1 or 1-800-833-6384. E-Verify is a registered trademark of the U.S. Department of Homeland Security."