A class incumbent is responsible for handling all medical relations issues that pertain to accurate adjudication of disability claims and for supervising the consultative examination scheduling unit.
- Supervises medical consultants.
- Supervises Consultative Examination Scheduling Unit (composed of 2 secretarial positions).
- Supervises medical data collection couriers under contract with DDS.
Nature and Scope
A class incumbent functions under the direction of an Administrator of Disability Determination Services. The incumbent in this position is involved in developing, coordinating, implementing and maintaining a medical relations program for the DDS. This program plays a vital part in insuring that the disability adjudicative staff have adequate information to adjudicate cases. A significant aspect of the class involves maintaining effective communication with doctors and medical records departments throughout the state to facilitate the timely receipt of medical evidence of record. In addition the class incumbent manages the consultative exam program including recruiting physicians and facilities to provide services to the agency and supervising a small secretarial staff that schedules the examinations. Other aspects of the work include directing the in-house medical consultant staff, investigating complaints received from claimants, resolving billing problems with vendors and keeping the medical community informed of the operations and functions of the DDS.
Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
- Maintains liaison with providers of medical evidence of record in order to expedite the receipt of sufficient information so that prompt and accurate disability decisions can be made; performs program audits on medical evidence of record; processes and recommends corrective action when appropriate.
- Recruits in-house medical consultants, assists with their training in technical aspects of the DDS program, coordinates work schedules of physicians and monitors compliance with conditions of contracts.
- Recruits and approves new consultative physicians and facilities for the purpose of performing disability evaluations; implements a system for evaluating their work to determine compliance with program scheduling, fiscal, examination and reporting requirements; performs program audits and recommends corrective action when appropriate.
- Directly supervises the consultative examination scheduling unit to insure that examinations are scheduled in a timely and efficient manner.
- Establishes and maintains an agency fee schedule for medical sources.
- Designs and implements special studies to monitor the procurement of medical evidence of record, supervises a medical data collection system and recommends techniques to improve procurement of data.
- Investigates complaints concerning adjudicative staff or medical consultants to resolve problems.
- Represents DDS at medical conventions and other professional meetings to keep the medical community informed of agency operations and functions.
- Develops and coordinates public relations presentations and materials to disseminate information concerning various aspects of the SSA disability program.
Knowledge, Skills and Abilities
The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA’s listed are not exhaustive or necessarily inclusive of the requirements of every position in the class.
- Knowledge of Federal laws, rules and regulations dealing with disability programs under the Social Security Act.
- Knowledge of the medical community and medical organizations within the State.
- Knowledge of the interdependency of all DDS units, workflow procedures, and internal operations.
- Knowledge of medical terminology and technology, body systems, medical testing procedures, and clinical documentation procedures in order to communicate effectively with physicians and other medical vendors.
- Knowledge of the informational and data systems of SSA and the Division and State fiscal data system.
- Ability to establish and maintain effective working relationships with organizations and individuals interested in or affected by SSA.
- Ability to provide public information and respond to inquiries about the DDS program.
- Ability to monitor DDS medical program, and evaluate results.
- Ability to communicate with all medical specialties and recruit medical doctors to meet the changing consultative examination needs of the program.
- Ability to develop and conduct educational presentations, seminars and workshops.
- Ability to identify and quickly resolve medical data collection.
JOB REQUIREMENTS for Disability Determination Medical Relations Officer
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:
- Six months experience in evaluating disability claims and making disability determinations.
- Three years experience in interpreting Social Security Administration laws, rules, regulations, standards, policies and procedures.
- Six months experience in medical terminology.
- Six months experience in narrative report writing.
- Knowledge of interacting with medical organizations such as hospitals, clinics, professional organizations, civic organizations, or other community resources.
- Knowledge of staff supervision of two or more employees which includes to plan, assign, review, discipline, recommend hire, promotion, termination and administer performance plans and reviews.