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Disability Quality Assurance Coordinator
The Disability Quality Assurance (QA) Coordinator is responsible for overseeing the quality control of disability claims processing. This role ensures that all disability determinations are accurate, compliant with regulations, and meet quality standards set by the state.
Class Code:
PDI12C
Job Grade:
SGS10
Special Job Requirements:
Typical Functions:
Conduct regular audits and reviews of disability claim decisions to ensure compliance with state and federal regulations. Identify trends in decision-making errors and provide feedback to adjudicators to improve the quality of outcomes. Develop and implement procedures for quality assurance reviews and continuous improvement efforts. Provide training to staff on quality standards, regulatory changes, and best practices for disability adjudication. Prepare reports on audit results and make recommendations to improve processes.
Knowledge, Abilities, and Skills:
Strong understanding of disability law, adjudication procedures, and quality assurance methods. Analytical skills to evaluate case quality and provide actionable feedback. Excellent communication skills to present findings clearly to various stakeholders. Detail-oriented with the ability to identify inconsistencies and areas for improvement. Ability to work collaboratively with adjudicators and management to implement improvements.
Minimum Qualifications:
The formal education equivalent of a bachelor’s degree in social work, psychology, sociology, biological, life sciences, or related field. At least 4 years of experience in disability claims adjudication, with 2 years in a supervisory or expert capacity.
Required Certificates:
N/A 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.
Exempt:
E