CLAIMS ADJUDICATOR TRAINEE DISABILITY DETERMINATIONS
There is no civil service exam for Claims Adjudicator Trainee Disability Determinations. As a non-competitive state title, it is filled on the strength of meeting the listed qualifications.
It lists a bachelor's degree as the baseline, with an experience-based path open to those who do not hold the degree. State payroll currently lists about 37 people in the title, most of them at Labor.
How to get hired
- Claims Adjudicator Trainee Disability Determinations is non-competitive, so there is no ranked exam. You qualify by meeting the education and experience stated in the specification.
- Apply directly to the hiring agency when a vacancy is posted. The agency verifies that you meet the minimum requirements.
- Because there is no eligible list, hiring timelines are set by the agency rather than by a statewide certification.
Read the official specification at NJ Civil Service Commission.
Who employs this title
State payroll records show 37 people working under this title. The median actual salary is $124,366. The agencies employing the most are:
- Labor (37)
Counts from NJ YourMoney agency payroll. See statewide workforce analytics.
Official job specification
The text below is the official specification published by the New Jersey Civil Service Commission. The plain-language summary and analysis above are derived from it by NJ Civil Service Navigator.
Definition
Under close supervision of a Claims Adjudicator Supervisor or other supervisory official, as a trainee and productive worker, reviews applications and develops medical and nonmedical data to make determinations of disability in accordance with the provisions of the Social Security Disability and Supplemental Security Income Disability Programs; assists in the processing and closing of other types of insurance claims according to applicable state laws as required; documents decisions by selective development of vocational or other data; does related work as required.
Examples of work
As a trainee and productive worker: Learns to assist in reviewing cases referred by Social Security District Offices or insurance carriers and prepares a work sheet of the case containing demographic characteristics, available medical evidence, and such nonmedical evidence as substantial gainful activity engaged subsequent to the alleged onset date. Learns to prepare clear and accurate determinations containing findings, conclusions, and recommendations in all initial claims. Learns to evaluate data and reexamines data based on medical documentation. Learns to review information to determine if claimants can functionally perform their relevant work or if additional information is necessary and takes appropriate action. Learns to communicate with treating physicians, hospitals, and other medical sources to elicit the required medical data. Learns to communicate with claimant to obtain any required additional information and all vocational data prior to onset of disability. Learns to obtain additional medical data, as recommended by the review physician; obtains nonmedical data, including data relating to vocational factors, when so required, from applicants, treating physicians, hospitals and clinics. Learns to evaluate applicants' work records and verifies the alleged onset date of disability. Contacts claimants to obtain their written permission to obtain additional medical evidence. Learns to assist in reviewing medical evidence and in determining the extent of an individual applicant's disability in accordance with the medical guides furnished by the Social Security Administration. Learns to confer with review physicians to determine residential functional limitations and capacities as they relate to claimant's ability to return to his or her former employment. Makes full use of available community resources, including the Veterans Administration, Vocational Rehabilitation Services, and Employment Services local offices, as required. Maintains essential records and files. Will be required to learn how to utilize various types of electronic and/or manual recording and computerized information systems used by the agency, office, or related units.
License
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
Knowledge, skills and abilities
Ability to understand current trends in the theories of social insurance, especially disability insurance. Ability to gain the confidence of general practitioners, medical specialists, and others, in order to elicit necessary case information leading to determinations of eligibility. Ability to profit by an in-service training program. Ability to comprehend, analyze, and interpret basic legislation, regulations, and procedures. Ability to comprehend and interpret medical evidence in support of diagnoses and use these data to make determinations of eligibility in accordance with standards developed by the Social Security Administration. Ability to review and analyze cases to determine the adequacy and currency of medical and related nonmedical data. Ability to prepare clear, sound, accurate, and informative case histories containing determinations of disability. Ability to maintain essential records and files. Ability to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. Ability to read, write, speak, understand, or communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible. ADVANCEMENT: Appointees who successfully complete the twelve-month (12) training period will be eligible for advancement to the title: Claims Adjudicator, Disability Determinations title in accordance with the New Jersey Civil Service Commission procedures. The inability of an employee in this trainee title to attain a level of performance warranting advancement to the title listed above shall be considered as cause for separation. This job specification is applicable to the following title code(s) which are different work week or work month and/or variants of the job class title: Job Spec Code State, Local or Common Class of Service Work Week State Class Code Local Class Code Salary Range
Note
The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. Appointments may be made to positions requiring bilingual skills. - Bilingual in Spanish and English SPECIAL SKILL: Applicants must be able to read, write, speak, understand, or communicate in Spanish and English sufficiently to perform the duties of this position. Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience. Four (4) years of professional experience in work involving the review of medical documentation and investigation of medical claims for eligibility determination of benefits or services. OR Possession of a bachelor's degree from an accredited college or university. "Professional experience" refers to work that is analytical, evaluative, and interpretive; requires a range of basic knowledge of the profession's concepts and practices; and is performed with the authority to act and make accurate and informed decisions. SN3595N/AP95-Bilingual In Spanish And EnglishSN3595N/AP95- This job specification is for government use only. Salary range is only applicable to state government. Local salaries are established by individual local jurisdictions. 1/23/2024