Disability Case Reviewer

Overview C2 ALASKA, LLC Remote The Disability Case Reviewer shall provide meaningful, prompt, reliable case services which requires the assessment of initial disability evidence and assessment of evidence during the reconsideration case process as well as non-case services where answers or opinions are provided regarding specific medical topics. Responsibilities CASE SERVICES Perform an independent review of all cases provided by SSA. The purpose of these reviews is to provide a medical assessment for the Disability Determination Services (DDS), Disability Processing Branch (DPB), Disability Processing Unit (DPU) or any other SSA adjudicating component. Not review or complete a medical assessment for any reconsideration case for which he/she provided the initial assessment. Not provide a medical assessment or review on any case he/she had any prior involvement in a treating capacity. Perform all reviews within a timely manner – time to complete a case varies based on case complexity reviewer experience; preferably within one business day of assignment but not to exceed two business days for review. Review all medical and non-medical evidence of record; including any prior file information. Identify and interpret all medical evidence, applying all current SSA disability policies and procedures. Request additional evidence, only when the evidence in the file is insufficient to assess in accordance with current SSA disability policies and procedures. Compose medical assessments (or opinions) in a professional manner, in a formal tone (third person), free of jokes, personal anecdotes, emotion, biases, prejudices or colloquial expressions. Write an independent narrative to convey their individualized review in a clear and concise manner. Complete independent case reviews within time frames established by the COR. Consult with staff and others (e.g., other MCs/PCs, medical providers, or Medical Advisors) as needed for the review of the case. Record findings in the agency electronic processing systems as specified by SSA case review policies and procedures. Attend required meetings, briefings, and workgroups necessary to perform independent case reviews (e.g., policy updates, procedural changes) or to discuss administrative issues related to the contract. Respond to all communications including, instant message or email within 48 hours of logging on to their laptop. Provide a satisfactory written assessment, free of spelling and grammatical errors that can be used by others in the disability program. Make required corrections to medical assessments when returned from the Office of Quality Review (OQR). Report suspected fraud identified in the course of the medical assessment. NON-CASE SERVICES (as ordered) Participate in presentations related to the contractor’s medical specialty and the application of disability policies; Provide consultation and expertise on policy development issues including written and/or oral summarizations; Participate in workgroups, visits, and meetings as requested by SSA to discuss issues related to the disability process; e.g., new medical technologies, revision of medical listings, and other policy issues (this does not include meetings, briefings, or workgroups necessary for independent case reviews); and Participate in mentoring or training activities with other Consultants. Other duties as assigned Qualifications Doctorate of Medicine or Osteopathy from an accredited college approved by the Council of Medical Education and Hospitals of the American Medical Association or Doctor of Osteopathy from a college accredited by the American Osteopathic Association. Completion of a residency and/or fellowship. Possess and maintain a Valid unrestricted license to practice medicine within one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands Minimum one (1) year experience practicing as an Internist. OR Doctor of Philosophy (Ph.D.) or (Psy.D.) degree in clinical or counseling psychology from an APA-accredited psychology program. Completion of an APA-approved clinical psychology internship Possess and maintain a Valid unrestricted license to practice within one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands Minimum of three (3) years of clinical experience within the last seven (7) years Minimum two (2) years of supervised clinical experience as a psychologist in health service, at least one (1) year of which is post master’s degree. Current Independent Case Reviewer status with the Social Security Department of Disability Service Preferred Qualifications: N/A Knowledge, Skills and Abilities: Knowledge of and ability to work in DCPS/NCPS, Disability Case Processing System, IMAGEN, eView/DMA Proficiency in the English Language- The MC/PC must be capable of providing a comprehensive, technically accurate and logically written document addressing the claimants medical evidence related to the rules of disability. Basic Computer Skills-MC/PC’s must be able to perform basic tasks with a compute, including, but not limited to sending and receiving email, conducting research, interacting with others via internet, creating and editing documents, spreadsheets,etc. Knowledge of the required education, training, experience, and documented current competence in the required specialty position description. Possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds. Ability to write in a clear, concise, grammatically correct manner. Knowledge and excellent computer skills including the use of computer software applications for drafting documents, data management, and tracking. This includes competency with Microsoft Office (Word, Excel, Teams, Outlook, PowerPoint). Physical Demands: (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.) While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee may use repeated motions that include the arms, wrists, hands and/or fingers. The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.