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DDSSA QUALITY ASSURANCE SPECIALIST
The Disability Determination for the Social Security Administration (DDSSA) Quality Assurance (QA) Specialist is responsible for performing substantive and technical review of all aspects of case development at case closure to determine whether documentation supports decisions, forms have been properly completed and case was otherwise processed in accordance with federal social security disability rules and regulations, and agency guidelines. This position is governed by state and federal laws and agency/institution policy.
Class Code:
X203C
Job Grade:
GS10
Special Job Requirements:
None
Typical Functions:
Reviews all types of social security disability claims at case closure for both substantive and technical quality in accordance with agency and QA internal business procedures.
Compiles statistical reports on substantive and technical errors according to agency guidelines within specified timeframes.
Serves as substantive and technical resource for adjudicative staff on all questions to ensure compliance with federal policy and resolves conflicts in policy interpretation.
Performs other duties as assigned.
Knowledge, Abilities, and Skills:
Knowledge of social security disability rules, regulations, advisory rulings, and court precedents.
Knowledge of medical terminology, procedures, anatomy, and disease processes.
Ability to coordinate and review the work of others.
Ability to apply social security disability rules and regulations to complex claims.
Ability to review and analyze medical evidence/records and understand information pertinent to social security rules and regulations.
Ability to analyze medical reports according to social security criteria and determine accuracy of decision, which includes accuracy of the medical decision as well as all vocational criteria, and any technical criteria set forth by the Social Security Administration.
Ability to communicate verbally and in writing.
Minimum Qualifications:
The formal education equivalent of a bachelorâ€Ã¢Ã‚„¢s degree in social work, psychology, sociology, or related field; plus four years of progressively more complex and varied experience in social security disability adjudication, including two years in a leadership capacity.
Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management.
OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
Required Certificates:
None
Exempt:
E
